PULSED DYE LASER AB-INTERNO SCLEROTOMY

GLAUCOMA IS A LEADING CAUSE OF IRREVERSIBLE BLINDNESS IN THEUNITED STATES. FILTRATION SURGERY IS THE PROCEDURE OF CHOICE WHEN MEDICAL THERAPY OR LASER TRABECULOPLASTY FAIL TOCONTROL THE INTRAOCULAR PRESSURE. IN THIS GRANT APPLICATION, A NON-INVASIVE LASER TREATMENT IS PROPOSED AS AN ALTERNATIVE TO FILTRATION SURGERY. THE LASER TO BE USED IS A CANDELA FLASHLAMP EXCITED DYE LASER EMITTING IN THE VISIBLE REGION OF THE SPECTRUM. BECAUSE VISIBLE LIGHT IS READILY TRANSMITTED BY THE CORNEA, A FISTULA WILL BE CREATEDBY THE LASER VIA AN AB-INTERNO APPROACH (FROM WITHIN), ALLOWING FOR CONTROLLED EGRESS OF AQUEOUS HUMOR FROM THE ANTERIOR CHAMBER OF THE EYE AND CONTROL OF INTRAOCULAR PRESSURE. A SLIT LAMP DELIVERY SYSTEM WILL BE DEVELOPED IN PHASE I OF THIS GRANT TO ACCOMPLISH AB-INTERNO DELIVERY OF LASER ENERGYTO THE EYE. THE OPTIMUM OPERATING PARAMETERS FOR CREATING A FILTRATION FISTULA USING THIS SYSTEM WILL THEN BE EVALUATED BOTH IN-VITRO AND IN-VIVO USING AN ANIMAL MODEL.