James B. Miller

Transvitreal carbon dioxide laser photocautery and vitrectomy.

A new form of carbon dioxide laser has been developed that allows placement of infrared energy within a fluid medium. Transvitreal photocautery, vitrectomy, and laser scalpel incisions have been accomplished utilizing this delivery modality of infrared energy. Clinical trials are presently underway.

Intraocular Carbon Dioxide Laser Photocautery: Indications and Contraindications at Vitrectomy

The indications and contraindications for the use of carbon dioxide laser photocautery at the time of vitrectomy have been reviewed. Indications include posterior retinal tears either in flat or elevated sensory retina; elevated fibrovascular fronds on the optic nerve or elsewhere; flat neovascularization elsewhere, bleeding rubeotic iris vessels. It is also used as a means of panretinal endophotocoagulation. Contraindications include flat disc neovascularization and areas within one disc diameter of the macula and nerve. The advantages and disadvantages of the 10.6 micrometer infrared wavelength of carbon dioxide laser photocautery are discussed.

Intraocular Carbon Dioxide Laser Photocautery: II. Preliminary Report of Clinical Trials

Carbon dioxide laser photocautery was used successfully intraocularly in human patients to seal fibrovascular fronds and retinal tears at the time of vitrectomy. Closure of rubeotic vessels in the iris was demonstrated histologically. The 10.6-microgram infrared radiation was delivered to the intraocular treatment site by means of 1.5-mm-diameter photocautery probe containing a 1.0-mm-diameter lumen closed at the end with an infrared transmitting window. Treatment was localized to the tissue adjacent to the window. Typical energy dosage was 0.4 W for 2 to 4 s duration. These early clinical trials were carried out under the guidelines established by the Food and Drug Administration; informed consent clearly outlined the experimental nature of these studies.

Miniaturized Intraocular Carbon Dioxide Laser Photosurgical System for Multi-Incision Vitrectomy

Abstract A new smaller form of carbon dioxide laser photosurgery has been developed to conform to standard multi-incision closed vitrectomy techniques. The carbon dioxide laser photocautery probes and the wetfield carbon dioxide laser scalpel have been reduced in size to a 20-gauge outside diameter. The similar time and power parameters as previously described are still applicable.