Erbium:YAG laser vitrectomy: clinical results.
OBJECTIVE
To evaluate the intraoperative use of a new erbium:yttrium aluminum garnet (YAG) laser vitrectomy system.


METHODS
An erbium:YAG laser combined with an infusion-suction system (Wavelight 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. Between January 1998 and January 1999 the erbium:YAG laser system was used in 67 consecutive patients (68 eyes) where vitrectomy was indicated. The patients had a complete eye examination before surgery and postoperatively at 1 to 3 days, 1 week, 3 weeks, and 6 weeks. During surgery, the total time needed 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, loose intravitreal, and preretinal membranes of different densities were cut well 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 with mechanical vitrectomy cutters, are higher cutting rates and the modulation of energy. Modifications of the end tip are needed to develop this system further.
Binder
S
S
Boltzmann Institute for Retinology and Biomicroscopic Laser Surgery, Department of Ophthalmology, Rudolf Foundation Hospital, Vienna, Austria. susanne.binder@kar.magwien.gv.at
Stolba
U
U
Kellner
L
L
Krebs
I
I
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012164:Retinal Diseases / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D014821:Vitrectomy / Q000295:instrumentation / Q000379:methods*