ONE JOULE DIODE LASER FOR GLAUCOMA TREATMENT

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Recent developments at Spire have led to the availability of three joule pulsed diode laser arrays. The proposed Phase I research study is designed to establish the feasibility of an inexpensive fiber-coupled, two- dimensional laser diode array generating one joule of pulsed energy to vaporize and drill sclerostomies in scleral tissue prestained with a chromophobe such as indocyanine green dye. Unlike present commercially available continuous-wave diode lasers which only photocoagulate tissue, the proposed device would generate sufficient energy to precisely vaporize stained soft tissue with a single laser pulse. Single-pulse instruments with one joule of peak power at 800 nm are not now commercially available. The laser design to be used would incorporate arrays of cylindrical microlenses to collimate the output of a diode array, focusing it into an optical fiber. The envisioned diode laser instrument would be useful for both invasive and non-invasive internal sclerostomy procedures, as well as external subconjunctival sclerostomies. As such, it would be a versatile and highly useful device for the treatment of refractory open-angle glaucoma. The same instrument may also prove useful for other glaucoma treatment procedures, such as trabeculoplasty and transscleral cyclophotocoagulation. Preliminary studies indicate that it is possible to obtain sufficient chromophobe in human scleral tissue that vaporization can be accomplished with a one joule pulse of 800 nm laser energy.