Acute optic nerve sheath fenestration in humans using the free electron laser (FEL): a case report

Karen Margaret Joos M.D.; Louise A. Mawn M.D.; Jin-Hui Shen; E. Duco Jansen; Vivien A. Casagrande

doi:10.1117/12.470579

13 June 2002 Acute optic nerve sheath fenestration in humans using the free electron laser (FEL): a case report

Karen Margaret Joos M.D., Louise A. Mawn M.D., Jin-Hui Shen, E. Duco Jansen, Vivien A. Casagrande

Proceedings Volume 4611, Ophthalmic Technologies XII; (2002) https://doi.org/10.1117/12.470579
Event: International Symposium on Biomedical Optics, 2002, San Jose, CA, United States

Abstract

Our previous studies using rabbits and monkeys showed that the Amide II wavelength (6.45 micrometers ) produced by the FEL could efficiently produce an optic nerve sheath fenestration with minimal damage. In order to determine if the technology safely could be applied to human surgery, we used 2 blind human eyes during enucleation to compare the results of producing fenestrations with the FEL or a scissors. FDA and Vanderbilt IRB approvals, and individual patient consents were obtained. The FEL energy was transmitted to a human operating room. After disinsertion of the medial rectus muscle, an optic nerve sheath fenestration (2 mm diameter) was made with either the FEL (6.45 micrometers , 325 micrometers spot size, 30 Hz, 3 mJ) through a hollow waveguide surgical probe or with a scissors. The enucleation was then completed. The optic nerve was dissected from the globe and fixed. Specimens were examined histologically. Dural incisions were effective with both methods. FEL energy at 6.45 micrometers can be transmitted to an operating room and delivered to human ocular tissue through a hollow waveguide surgical probe. This FEL wavelength can produce an optic nerve sheath fenestration without acute direct damage to the nerve in this case report.

Citation Download Citation

Karen Margaret Joos M.D., Louise A. Mawn M.D., Jin-Hui Shen, E. Duco Jansen, and Vivien A. Casagrande "Acute optic nerve sheath fenestration in humans using the free electron laser (FEL): a case report", Proc. SPIE 4611, Ophthalmic Technologies XII, (13 June 2002); https://doi.org/10.1117/12.470579

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