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August 1989

Ab Interno Sclerostomy With a High-Powered Argon Endolaser: Clinicopathologic Correlation

Author Affiliations

From the Department of Ophthalmology, Medical College of Wisconsin, Milwaukee (Drs Jaffe, Mieler, Radius, Massaro, and Abrams), and the Bethesda Eye Institute, Departments of Ophthalmology and Pathology, St Louis University, Mo (Dr Kincaid).

Arch Ophthalmol. 1989;107(8):1183-1185. doi:10.1001/archopht.1989.01070020249034

• A high-powered argon blue-green laser coupled to a 300-μm quartz fiberoptic probe was used to create an ab interno sclerostomy in a patient undergoing enucleation for a blind painful eye. Despite the presence of diffuse rubeosis, 360° peripheral anterior synechiae, and superior conjunctival scarring, it was possible to create a full-thickness defect from the anterior chamber angle to the subconjunctival space without operative complications. Six laser applications were required using 8 W of power per pulse and 0.1-second pulse duration. The eye was enucleated immediately after the laser procedure, prepared for light microscopy, and sectioned serially. Histologic analysis demonstrated a patent fistula approximately 300 μm in diameter with sharp wound margins. Tissue damage was localized to within 150 μm of the sclerostomy. The overlying conjunctiva was intact.

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