Laser Deep Sclerectomy for glaucoma treatment
Kozobolis V. and Pallikaris I.

Department of Ophthalmology, Medical School, Heraklion University, Crete, Greece

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 мsec, 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: 200м, Size of sup. scleral flap: 5mm X 5mm, Size of photoablated area: 3mm 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 14.28%, hypheama in 11.42%, leakage in 1 eye, cystic bleb or bleb fibrosis in 17.14%.
Conclusions: LDS is a new and safe surgical procedure for Glaucoma treatment. The scleral and the corneal ablation are performed in a step-by-step fashion. The healing process could be influenced by the application of Erbium Yag laser.