Purpose: The formation of a filtrative area, using
the Erbium Yag Laser, over the trabeculum, the Schlemm’s canal and the
Descemet’s membrane, in order to permit the percolation of acqueous humor from
the anterior chamber to the subconjunctival space
Setting: We use the CentauriTM Erbium Yag-laser
(Premiere), solid state - 2940 nm
Pulse Rate: 10 - 30 Hz, Output Energy: -250 mJ at 10 Hz,
Pulse Width: 300 μsec, Aiming Beam: Green Helium Neon Laser
Methods: Forty five eyes of 45 patients (26 males and
19 females) suffered from POAG and PEXG underwent the LDS
(Thickness of superficial scleral flap: 250μ, Size
of sup. scleral flap: 5mm X 5mm,
Size of photoablated area: 4mm X
4mm, Repetition rate:10 Hz & Energy: 10mJ)
Results: The IOP was decreased from 26.37 +
3.41 to 16.54 + 3.55 mmHg in a follow – up period of 13.34 + 5.70
months (3 – 18months). The mean number of medication was also decreased from
2.88 + 0.71 drugs to 1.18 + 0.80. Concerning the complications,
choroidal detachment was found in
13.33%, hypheama in 11.11%, leakage in 1 eye, cystic bleb or bleb
fibrosis in 17.14%
Conclusions: LS (Laser Sclerectomy) is a new and safe
surgical procedure for Glaucoma treatment. The scleral and the corneal ablation
are performed in a step by step fashion but microperforations could be created.
The healing process could be influenced by the application of Erbium Yag
laser. A longer follow up is required; in our view the problem to be
resolved, as in all antiglaucoma surgical procedures will be the healing
process.