Erbium : YAG laser vitrectomy: Clinical results

PURPOSE: To evaluate the intraoperative use of a new erbium:yttrium aluminu m garnet (YAG) laser vitrectomy system. METHODS: An erbium:YAG laser combined with an infusion-suction system (Wave light Laser Technology, Erlangen, Germany), equipped with a flexible fiber optic and a hand piece with a 20-gauge end tip and a side opening of 0.6 mm was used. Cutting rates were 2 to 30 Hz, and energies were 20 to 40 mJ. Be tween January 1998 and January 1999 the erbium:YAG laser system was used in 67 consecutive patients (68 eyes) where vitrectomy was indicated. The pati ents had a complete eye examination before surgery and postoperatively at 1 to a days, 1 week, 3 weeks, and 6 weeks. During surgery, the total time ne eded for vitrectomy, the laser time itself, amount of energy used, cutting rate, suction, and perfusion, as well. as manipulative difficulties and/or complications, were documented. RESULTS: The average laser time was 4.5 minutes for a basic vitrectomy with a setting of 20 mJ, 20 Hz, and suction 100 to 200 mm Hg, Hemorrhages, loos e intravitreal, and preretinal membranes of different densities were cut we ll with adjustment of energy. After a minimal observation time of 6 months (median, 12.7 months) no laser-associated complications were found. CONCLUSIONS: The erbium:YAG laser, combined with an infusion-suction system , offers a new technology for vitreous surgery. Its advantages, compared wi th mechanical vitrectomy cutters, are higher cutting rates and the modulati on of energy. Modifications of the end tip are needed to develop this syste m further. (C) 2000 by Elsevier Science Inc. All rights reserved.