Flexible UV light guiding system for intraocular laser microsurgery.

BACKGROUND AND

OBJECTIVE

Until now, UV lasers could not be applied to vitreoretinal surgery because of the absence of a practical beam guiding system. A flexible, freely mobile hollow core waveguide, capable of delivering UV laser light, was recently developed. We evaluated the feasibility of this UV laser guiding system for vitreoretinal surgery in enucleated porcine and rabbit eyes and in vivo on rabbit retina.

MATERIALS AND

METHODS

193-nm argon fluoride (ArF) excimer laser and a 5th harmonic Nd:YAG laser with the wavelength of 213 nm were used as a light source. A hollow core waveguide was connected to a handpiece with a 20-gauge endoprobe as an instrument for vitreoretinal surgery.

RESULTS

Cutting of the retina was possible only with contact technique. With a selected repetition rate of 20 Hz, sharp, full-depth dissection of porcine retinas was achieved only with 1.0 J/cm2. With the repetition rate of 50 Hz, even 0.05 J/cm2 could incise the total thickness of rabbit retina with no histological damage of the underlying retinal pigment epithelium. The ease in using the instrument for vitreoretinal surgery was confirmed by the in vivo experiment.

CONCLUSION

This study revealed the potential use of the new type of the UV laser scalpel, connected to a hollow core waveguide, to perform precise, "cold," and tractionless cutting during vitreoretinal surgery.