Quantification of holmium:YAG and thulium:YAG laser-induced scleral shrinkage for buckling procedures

Mikio Sasoh, Jean Marie Parel, Fabrice Manns, Izuru Nose, Jason Comander, William E. Smiddy

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


BACKGROUND AND OBJECTIVE: To quantify and compare holmium:YAG (2.1 μm) and thulium:YAG (2.0 μm) laser-induced scleral shrinkage for retinal buckling procedures. MATERIALS AND METHODS: Two overlapping spots of either laser radiation were applied at the equatorial sclera of 50 human cadaver eyes. Scleral shrinkage was expressed as a relative change of length between two reference points on the scleral surface, and quantified as a function of energy per pulse, total energy, scleral thickness, and intraocular pressure (IOP). Tissue effects were studied histopathologically. RESULTS: Shrinkage was most dependent on total fluence and attained a maximum of 27% to 30% with an IOP of 4 mm Hg, regardless of scleral thickness or laser parameters, but decreased with increasing IOP. The thulium:YAG laser produced more efficient scleral shrinkage and less collagen damage than the holmium:YAG laser. CONCLUSION: The recommended parameters for laser-induced scleral shrinkage are the thulium:YAG laser, with 2.4 J/cm2 per pulse and 12.0 to 14.4 J/cm2 total fluence (5 to 6 pulses). IOP control (≤ 4 mm Hg) is crucial during laser scleral buckling.

Original languageEnglish (US)
Pages (from-to)410-421
Number of pages12
JournalOphthalmic Surgery and Lasers
Issue number5
StatePublished - May 1998

ASJC Scopus subject areas

  • Ophthalmology


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