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Iridocoreneal Surgery and Intaoperative Control by UBM - An Experimental Study

Dietlein T., Engels B. F., Jacobi P. C., Krieglstein G. K.,
Universität zu Köln, Zentrum für Augenheilkunde (Köln)

Purpose: A major problem of photoablative trabecular surgery is the lack of an adequate intraoperative control. Ultrasound biomicroscopy (UBM) may be a promising option in this field.
Method: In 10 porcine cadaver eyes we performed Erbium:YAG laser trabecular ablation only guided by UBM. In order to reduce movement artefacts, the endoprobe was fixed by an instrument holder and slowly screwed forward.
Results: The silhouette of the endoprobe, the endoprobe-tissue-contact and the distortion of the tissue owing to applanation force could be exactly visualized. Quantitative measurements of the ablation depth and detailed topographic localization of the ablation craters revealed limited value owing to resolution capacity.
Conclusions: Technique and safety of trabecular surgery can be improved by use of UBM. Before starting UBM-guided ab-interno surgery in clinical practice, some essential innovations (resolution capacity, equipment handling) are necessary.

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