The holmium:yttrium aluminum garnet (Ho:YAG) laser produces infrared light that is absorbed inside scleral tissues, which increases local temperature, thereby shrinking collagen and inducing a buckle effect. Scleral indentation was induced in ten cadaver eyes by shrinkage of scleral collagen fibers by using a pulsed solid-state Ho:YAG (2.1-μm) laser with fiberoptic delivery. The amount of laser-induced buckling effect is controlled by selecting laser treatment settings such as beam spot, radiant exposure, and number of pulses. With treatment using 11.3 ± 1.2 J/cm2 of laser radiant exposure and five pulses, laser-induced scleral shrinkage affected only the external two thirds of the scleral tissue. No thermal damage of disruption was observed in subjacent retinal pigment epithelium, choroid, or retina. The coupling of two appropriately selected lasers may allow laser-induced scleral buckling and transscleral retinal photocoagulation by using the same laser probe for retinal reattachment.
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