Femtosecond Laser Trabeculotomy in Perfused Human Cadaver Anterior Segments: A Novel, Noninvasive Approach to Glaucoma Treatment.
Femtosecond Laser Trabeculotomy in Perfused Human Cadaver Anterior Segments: A Novel, Noninvasive Approach to Glaucoma Treatment.
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DOI：
10.1167/tvst.11.3.28
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发表时间：
2022-03-02
影响因子：
3
通讯作者：
Juhasz T
中科院分区：
文献类型：
--
作者：
Mikula ER;Raksi F;Ahmed II;Sharma M;Holland G;Khazaeinezhad R;Bradford S;Jester JV;Juhasz T
本研究旨在以临床相关方式研究飞秒激光小梁切开术（FLT）（即，通过完整的人眼前节的角膜输送手术激光束，以产生从前房进入施累姆氏管的通道），并研究这种治疗对灌注的人眼前节中的眼内压的影响。灌注的人眼前节（15只眼）接受FLT治疗（n = 8）或假治疗（n = 7）。在治疗前后记录灌注样品中的眼内压（IOP）。光谱域光学相干层析成像，二次谐波产生成像，和透射电子显微镜被用来调查FLT通道。FLT集团（n = 7，排除1只眼）治疗后平均IOP较基线统计学显著降低20.2%（5.06 ± 1.46 mm Hg ~ 4.04 ± 1.63 mm Hg; P < 0.0005），而对照组（n = 7）在统计学上保持不变（7.72 ± 3.45 mm Hg至7.78 ± 3.51 mm Hg; P < 0.71）。成像证实，通道穿过整个小梁网进入施累姆氏管。本研究提供了支持临床适用的无创飞秒激光小梁切开术治疗青光眼可行性的第一个直接证据。各种成像模式显示对邻近组织的附带损伤最小。这项工作证明了在实验室环境中进行的无创飞秒激光小梁切开术具有临床相关性。
The purpose of this study was to investigate femtosecond laser trabeculotomy (FLT) in a clinically relevant manner (i.e., delivering the surgical laser beam through the cornea of the intact, human anterior segment to create channels from the anterior chamber into the Schlemm's canal) and to investigate the effect of this treatment on intraocular pressure in perfused human anterior segments. Perfused human anterior segments (15 eyes) received either FLT treatment (n = 8) or a sham-treatment (n = 7). Intraocular pressure (IOP) in the perfused samples was recorded before and after treatment. Spectral domain optical coherence tomography, second harmonic generation imaging, and transmission electron microscopy were used to investigate the FLT channels. The FLT group (n = 7, 1 eye excluded) had a statistically significant reduction in mean IOP of 20.2% from baseline after treatment (5.06 ± 1.46 mm Hg to 4.04 ± 1.63 mm Hg; P < 0.0005), whereas the control group (n = 7) remained statistically unchanged (7.72 ± 3.45 mm Hg to 7.78 ± 3.51 mm Hg; P < 0.71). Imaging confirmed that the channels traversed the entire trabecular meshwork into the Schlemm's canal. This study has provided the first direct evidence supporting the feasibility of clinically applicable, noninvasive femtosecond laser trabeculotomy for the treatment of glaucoma. Various imaging modalities revealed minimal collateral damage to adjacent issues. This work demonstrates noninvasive femtosecond laser trabeculotomy in a laboratory setting that is clinically relevant.
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