One Joule Diode Laser for Glaucoma Treatment

Recent developments have led to the availability of three joule pulsed diode laser arrays. ThisPhase I research study is designed to establish the feasibility of an inexpensive fiber-coupled,two-dimensional laser diode array generating one joule of pulsed energy to vaporize and drillsclerostomies in scleral tissue prestained with a chromophobe such as indocyanine green dye. Unlikepresent commercially available continuous-wave diode lasers which only photocoagulate tissue, theproposed device would generate sufficient energy to precisely vaporize stained soft tissue with a singlelaser pulse. Single-pulse instruments with one joule of peak power at 800 nm are not now commerciallyavailable. The laser design to be used would incorporate arrays of cylindrical microlenses to collimatethe output of a diode array, focusing it into an optical fiber. The envisioned diode laser instrument wouldbe useful for both invasive and non-invasive internal sclerostomy procedures, as well as externalsubconjunctival sclerostomies. It would be a versatile and highly useful device for the treatment ofrefractory open-angle glaucoma. The same instrument may also prove useful for other glaucomatreatment procedures, such as trabeculoplasty and transscleral cyclophotocoagulation. Preliminarystudies indicate that it is possible to obtain sufficient chromophobe in human scleral tissue thatvaporization can be accomplished with a one joule pulse of 800 nm laser energy.