Comparison of erbium:yttrium–aluminum–garnet-laser vitrectomy and mechanical vitrectomy: A clinical study☆
Section snippets
Study groups
From November 1998 through January 1999, 30 eyes of 30 patients underwent vitrectomy by one surgeon (HP) at the Department of Ophthalmology, University of Dresden, Germany. The patients were recruited and randomly assigned to two study groups: Er:YAG laser vitrectomy (15 eyes) and mechanical vitrectomy (15 eyes). The demographic parameters of the patients are listed in Table 1.
Inclusion criteria for the two study groups were: (1) pathologic changes of vitreous in various degrees with and
Results
All 30 operations were uneventful and without complications. Additional scleral buckling (encircling band) was necessary in 6 cases, and 7 eyes needed silicone oil or temporary tamponade with SF6–air (four in the laser group, three in the mechanical vitrectomy group). In one eye in the laser group, a vitreous hemorrhage recurred.
Two surgical parameters, suction force and suction force variations, differed significantly in the two groups (Table 4). Because of the smaller adjusted maximal suction
Discussion
The key finding of this study is the clinical feasibility of a semicontinuous laser vitrectomy. A high cutting rate offers two options: (1) to accelerate the operation or (2) to make it smoother by lowering the suction force and, therefore, suction force variation. In this study, we followed the second strategy because small suction force variation induces small mechanical forces acting on intraocular structures, thus increasing the safety of the procedure. In this mode, the operation time
References (7)
Reminiscences after 25 years of pars plana vitrectomy
Am J Ophthalmol
(1995)- Charles S. Principles and techniques of vitreous surgery. In: Ryan SJ, ed. Retina, 2nd ed. St. Louis: Mosby, 1994; vol....
- et al.
Iatrogenic retinal breaks complicating pars plana vitrectomy
Ophthalmology
(1990)
Cited by (9)
Surgical solid-state lasers and their clinical applications
2013, Handbook of Solid-State Lasers: Materials, Systems and ApplicationsOptodynamic energy-conversion efficiency during an Er:YAG-laser-pulse delivery into a liquid through different fiber-tip geometries
2012, Journal of Biomedical OpticsAblation of vitreous tissue with a high repetition rate erbium:YAG laser
2003, European Journal of OphthalmologyThe use of the erbium Yag laser in cataract extraction and other applications in ophthalmic surgery
2002, Proceedings of SPIE - The International Society for Optical EngineeringLaser vitreolysis: A review
2002, Ophthalmologica
- ☆
Supported by the Brunenbusch-Stein Stiftung.
- 1
Dr. Mrochen is scientific consultant for Wavelight Inc., Erlangen, Germany. The other authors have no proprietary interest in the products described in this article.