Considerations and methods for laser surgery in the anterior and posterior segments.
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Biomedical subjects
Publications and source records attributed to P Rol.
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The specific advantages of a number of integrated optical systems, consisting of optical probes of various shapes and materials, coupled to a number of optical fibers are described. The radiation fields of the various systems vary significantly in their performance and the clinical effects may be expected to vary correspondingly. This is a step forward in the theoretical evaluation of optimal laser microsurgical tools for specific applications.
The optical performance of a new contact lens for observation and irradiation of the retina and choroid represents a compromise between Goldmann's contact lens and a wide-angle system in regard to magnification, resolution, and size of the field of view.
A contact lens designed for neodymium-YAG laser posterior capsulotomy which angulates the beam with respect to the posterior capsule is presented. This lens may minimize injury to the corneal endothelium.
The effects upon the iris of radiation emitted by a Nd:YAG laser working in its thermal (free-running) mode and transmitted through the sclera were studied. The advantages and disadvantages of a fiber optic system, as compared to a conventional optical system, were studied using eight autopsy eyes. It was shown that the conventional optical system as well as a fiber optic system are both able to perforate the iris completely and to blast away or destroy the pigment epithelium. One merit of the fiber optic system as compared to the conventional system is that it requires considerably less energy for the same effect. This is partially because the sclera, when compressed, becomes more transparent and thus transmits a greater amount of laser energy.
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Effective and safe photodisruption requires that the laser pulse be brought to a fine focus. Contact lenses are generally required to compensate for the optical aberrations of the eye which degrade the laser focus. The theoretical analysis of these aberrations has led to the construction of a contact lens which minimizes aberrations in the posterior vitreous. Clinical applications confirm the increased efficacy and safety of posterior vitreous photodisruption using this contact lens.
A number of aiming/focusing systems, oriented toward guiding the treatment beams of photodisruptive, high power Nd:YAG lasers, are analyzed and evaluated. A system, consisting of two frequency modulated, rotating laser beams, which outline the Nd:YAG laser beam shape, is shown to be the optimal solution.
The effects of a neodymium: YAG laser, working in the free-running mode (1 and 20 millisecond pulses), upon the ciliary body via the transscleral route have been studied using 16 autopsy eyes. The experiments described were designed to find an efficient strategy of transscleral cyclodestruction of the ciliary body. It was found that pulse energies of between 6 and 7 Joules, an exposure duration of 20 milliseconds, and maximal defocusing are optimal. A beam, tangentially oriented and positioned 1/2 to 1 mm posterior to the limbus has a high probability of hitting the ciliary body and damaging the ciliary processes. In these experiments a first generation of contact lenses could not be demonstrated to have an advantageous effect.
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