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Late Histopathological Findings of Neodymium:YAG Laser Iridotomies in Humans

Late Histopathological Findings of Neodymium:YAG Laser Iridotomies in Humans Abstract • We studied three sector iridectomy specimens from three patients who had undergone neodymium:YAG (Nd:YAG) laser iridotomies 3 to 5 years earlier for treatment of imminent angle closure glaucoma. The specimens were obtained during cataract extraction and were examined by light and transmission electron microscopy. In all iris specimens, the edges of the iridotomy sites consisted of loosely arranged melanocytes, fibrocytes, and vessels. In the iris stroma, there were numerous pigment-laden cells. The iris vessels appeared to be intact; there were no fibrinous aggregates, no inflammatory response or scarring, nor any signs of proliferation of the iris pigment epithelium. Our findings suggest that in humans, iris wound healing after Nd:YAG laser iridotomy occurs without induction of fibrous scars or proliferation of the iris pigment epithelium. This indicates that there is no tendency toward late closure of the iridotomy sites. References 1. Fankhauser F. The Q-switched laser: principles and clinical results . In: Trokel SL, ed. YAG Laser Ophthalmic Microsurgery . East Norwalk, Conn: Appleton & Lange; 1983:101-146. 2. Robin AL, Pollack IP. A comparison of neodymium:YAG and argon laser iridotomies . Ophthalmology . 1984;91:1011-1016.Crossref 3. Ritch R, Palmberg P. Argon laser iridectomy in densely pigmented irides . Am J Ophthalmol . 1982;93:800-801. 4. Stetz D, Smith H Jr, Ritch R. A simplified technique for laser iridectomy in blue irides . Am J Ophthalmol . 1983;96:249-251. 5. Klapper RM. Q-switched neodymium:YAG laser iridotomy . Ophthalmology . 1984;91:1017-1021.Crossref 6. Schwartz LW, Moster MR, Spaeth GL, Wilson RP, Poryzees E. Neodymium-YAG laser iridectomies in glaucoma associated with closed or occludable angles . Am J Ophthalmol . 1986;102:41-44. 7. Moster MR, Schwartz LW, Spaeth GL, Wilson RP, McAllister JA, Poryzees EM. Laser iridectomy: a controlled study comparing argon and neodymium:YAG . Ophthalmology . 1986;93:20-24.Crossref 8. Dragon DM, Robin AL, Pollack IP, et al. Neodymium:YAG laser iridotomy in the cynomolgus monkey . Invest Ophthalmol Vis Sci . 1985;26:789-796. 9. Martin NF, Gaasterland DE, Rodrigues MM, Thomas G, Cummins CE III. Endothelial damage from retrocorneal mode-locked neodymium:YAG laser pulses in monkeys . Ophthalmology . 1985;92:1376-1381.Crossref 10. Martin NF, Gaasterland DE, Rodrigues MM, Thomas G, Cummins CE III. Endothelial damage thresholds for retrocorneal Q-switched neodymium:YAG laser pulses in monkeys . Ophthalmology . 1985;92:1382-1386.Crossref 11. Gaasterland DE, Rodrigues MM, Thomas G. Threshold for lens damage during Q-switched Nd: YAG laser iridectomy: a study of rhesus monkey eyes . Ophthalmology . 1985;92:1616-1622.Crossref 12. Latina MA, Puliafito CA, Steinert RR, Epstein DL. Experimental iridotomy with the Q-switched neodymium-YAG laser . Arch Ophthalmol . 1984;102:1211-1213.Crossref 13. Meyer KT, Pettit TH, Straatsma BR. Corneal endothelial damage with neodymium:YAG laser . Ophthalmology . 1984;91:1022-1027.Crossref 14. Khodadoust AA, Arkfeld DF, Caprioli J, Sears ML. Ocular effect of neodymium-YAG laser . Am J Ophthalmol . 1984;98:144-152. 15. Rodrigues MM, Spaeth GL, Moster M, Thomas G, Hackett J. Histopathology of neodymium: YAG laser iridectomy in humans . Ophthalmology . 1985;92:1696-1700.Crossref 16. Goldberg MF, Tso MOM, Mirolovich M. Histopathological characteristics of neodymium-YAG laser iridotomy in the human eye . Br J Ophthalmol . 1987;71:623-628.Crossref 17. Welch DB, Apple DJ, Mendelsohn AD, et al. Lens injury following iridotomy with a Q-switched neodymium-YAG laser . Arch Ophthalmol . 1986;104:123-125.Crossref 18. Berger CM, Lee DA, Christensen RE. Anterior lens capsule perforation and zonular rupture after Nd:YAG laser iridotomy . Am J Ophthalmol . 1989;107:674-675. 19. Naveh N, Zborowsky-Gutman L, Blumenthal M. Neodymium-YAG laser iridotomy in angle closure glaucoma: preliminary study . Br J Ophthalmol . 1987;71:257-261.Crossref 20. Remé C, Witmer R. Experimental iris suture observed by electron microscope: a preliminary report . Graefes Arch Clin Exp Ophthalmol . 1973;188:109-116.Crossref 21. Hinzpeter EN, Naumann G, Demeler U. Healing of iris wounds after experimental iridotomies with two sutures . Graefes Arch Clin Exp Ophthalmol . 1974;191:215-229.Crossref 22. Hanna C, Roy H. Iris wound healing . Arch Ophthalmol . 1972;88:296-304.Crossref 23. Hinzpeter EN, Naumann G, Ortbauer R. Healing of a sutured iridotomy in man . Ophthalmologica . 1974;169:390-396.Crossref 24. Demeler U, Hinzpeter EN, Bujara K. Die Einflüsse von Kortikosteroiden auf die Iriswundheilung beim Kaninchen . In: Naumann GOH, Gloor B, eds. Wundheilung des Auges und ihre Komplikationen . Munich, Germany: Bergmann; 1980: 325-330. 25. Quigley HA. Long term follow-up of laser iridotomy . Ophthalmology . 1981;88:218-224.Crossref 26. Schwartz LW, Rodrigues MM, Spaeth GL, Streeten B, Douglas C. Argon laser iridotomy in the treatment of patients with primary angleclosure or pupillary block glaucoma: a clinicopathologic study . Ophthalmology . 1978;85:294-309.Crossref 27. Priore LVD, Robin AL, Pollack IP. Neodymium:YAG and argon laser iridotomy: long-term follow-up in a prospective, randomized clinical trial . Ophthalmology . 1988;95:1207-1211.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Late Histopathological Findings of Neodymium:YAG Laser Iridotomies in Humans

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Publisher
American Medical Association
Copyright
Copyright © 1992 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1992.01080200099033
Publisher site
See Article on Publisher Site

Abstract

Abstract • We studied three sector iridectomy specimens from three patients who had undergone neodymium:YAG (Nd:YAG) laser iridotomies 3 to 5 years earlier for treatment of imminent angle closure glaucoma. The specimens were obtained during cataract extraction and were examined by light and transmission electron microscopy. In all iris specimens, the edges of the iridotomy sites consisted of loosely arranged melanocytes, fibrocytes, and vessels. In the iris stroma, there were numerous pigment-laden cells. The iris vessels appeared to be intact; there were no fibrinous aggregates, no inflammatory response or scarring, nor any signs of proliferation of the iris pigment epithelium. Our findings suggest that in humans, iris wound healing after Nd:YAG laser iridotomy occurs without induction of fibrous scars or proliferation of the iris pigment epithelium. This indicates that there is no tendency toward late closure of the iridotomy sites. References 1. Fankhauser F. The Q-switched laser: principles and clinical results . In: Trokel SL, ed. YAG Laser Ophthalmic Microsurgery . East Norwalk, Conn: Appleton & Lange; 1983:101-146. 2. Robin AL, Pollack IP. A comparison of neodymium:YAG and argon laser iridotomies . Ophthalmology . 1984;91:1011-1016.Crossref 3. Ritch R, Palmberg P. Argon laser iridectomy in densely pigmented irides . Am J Ophthalmol . 1982;93:800-801. 4. Stetz D, Smith H Jr, Ritch R. A simplified technique for laser iridectomy in blue irides . Am J Ophthalmol . 1983;96:249-251. 5. Klapper RM. Q-switched neodymium:YAG laser iridotomy . Ophthalmology . 1984;91:1017-1021.Crossref 6. Schwartz LW, Moster MR, Spaeth GL, Wilson RP, Poryzees E. Neodymium-YAG laser iridectomies in glaucoma associated with closed or occludable angles . Am J Ophthalmol . 1986;102:41-44. 7. Moster MR, Schwartz LW, Spaeth GL, Wilson RP, McAllister JA, Poryzees EM. Laser iridectomy: a controlled study comparing argon and neodymium:YAG . Ophthalmology . 1986;93:20-24.Crossref 8. Dragon DM, Robin AL, Pollack IP, et al. Neodymium:YAG laser iridotomy in the cynomolgus monkey . Invest Ophthalmol Vis Sci . 1985;26:789-796. 9. Martin NF, Gaasterland DE, Rodrigues MM, Thomas G, Cummins CE III. Endothelial damage from retrocorneal mode-locked neodymium:YAG laser pulses in monkeys . Ophthalmology . 1985;92:1376-1381.Crossref 10. Martin NF, Gaasterland DE, Rodrigues MM, Thomas G, Cummins CE III. Endothelial damage thresholds for retrocorneal Q-switched neodymium:YAG laser pulses in monkeys . Ophthalmology . 1985;92:1382-1386.Crossref 11. Gaasterland DE, Rodrigues MM, Thomas G. Threshold for lens damage during Q-switched Nd: YAG laser iridectomy: a study of rhesus monkey eyes . Ophthalmology . 1985;92:1616-1622.Crossref 12. Latina MA, Puliafito CA, Steinert RR, Epstein DL. Experimental iridotomy with the Q-switched neodymium-YAG laser . Arch Ophthalmol . 1984;102:1211-1213.Crossref 13. Meyer KT, Pettit TH, Straatsma BR. Corneal endothelial damage with neodymium:YAG laser . Ophthalmology . 1984;91:1022-1027.Crossref 14. Khodadoust AA, Arkfeld DF, Caprioli J, Sears ML. Ocular effect of neodymium-YAG laser . Am J Ophthalmol . 1984;98:144-152. 15. Rodrigues MM, Spaeth GL, Moster M, Thomas G, Hackett J. Histopathology of neodymium: YAG laser iridectomy in humans . Ophthalmology . 1985;92:1696-1700.Crossref 16. Goldberg MF, Tso MOM, Mirolovich M. Histopathological characteristics of neodymium-YAG laser iridotomy in the human eye . Br J Ophthalmol . 1987;71:623-628.Crossref 17. Welch DB, Apple DJ, Mendelsohn AD, et al. Lens injury following iridotomy with a Q-switched neodymium-YAG laser . Arch Ophthalmol . 1986;104:123-125.Crossref 18. Berger CM, Lee DA, Christensen RE. Anterior lens capsule perforation and zonular rupture after Nd:YAG laser iridotomy . Am J Ophthalmol . 1989;107:674-675. 19. Naveh N, Zborowsky-Gutman L, Blumenthal M. Neodymium-YAG laser iridotomy in angle closure glaucoma: preliminary study . Br J Ophthalmol . 1987;71:257-261.Crossref 20. Remé C, Witmer R. Experimental iris suture observed by electron microscope: a preliminary report . Graefes Arch Clin Exp Ophthalmol . 1973;188:109-116.Crossref 21. Hinzpeter EN, Naumann G, Demeler U. Healing of iris wounds after experimental iridotomies with two sutures . Graefes Arch Clin Exp Ophthalmol . 1974;191:215-229.Crossref 22. Hanna C, Roy H. Iris wound healing . Arch Ophthalmol . 1972;88:296-304.Crossref 23. Hinzpeter EN, Naumann G, Ortbauer R. Healing of a sutured iridotomy in man . Ophthalmologica . 1974;169:390-396.Crossref 24. Demeler U, Hinzpeter EN, Bujara K. Die Einflüsse von Kortikosteroiden auf die Iriswundheilung beim Kaninchen . In: Naumann GOH, Gloor B, eds. Wundheilung des Auges und ihre Komplikationen . Munich, Germany: Bergmann; 1980: 325-330. 25. Quigley HA. Long term follow-up of laser iridotomy . Ophthalmology . 1981;88:218-224.Crossref 26. Schwartz LW, Rodrigues MM, Spaeth GL, Streeten B, Douglas C. Argon laser iridotomy in the treatment of patients with primary angleclosure or pupillary block glaucoma: a clinicopathologic study . Ophthalmology . 1978;85:294-309.Crossref 27. Priore LVD, Robin AL, Pollack IP. Neodymium:YAG and argon laser iridotomy: long-term follow-up in a prospective, randomized clinical trial . Ophthalmology . 1988;95:1207-1211.Crossref

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Aug 1, 1992

References

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