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Proceedings Paper

Acute optic nerve sheath fenestration in humans using the free electron laser (FEL): a case report
Author(s): Karen Margaret Joos; Louise A. Mawn; Jin-Hui Shen; E. Duco Jansen; Vivien A. Casagrande
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Paper 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.

Paper Details

Date Published: 13 June 2002
PDF: 5 pages
Proc. SPIE 4611, Ophthalmic Technologies XII, (13 June 2002); doi: 10.1117/12.470579
Show Author Affiliations
Karen Margaret Joos, Vanderbilt Univ. (United States)
Louise A. Mawn, Vanderbilt Univ. (United States)
Jin-Hui Shen, Vanderbilt Univ. (United States)
E. Duco Jansen, Vanderbilt Univ. (United States)
Vivien A. Casagrande, Vanderbilt Univ. (United States)

Published in SPIE Proceedings Vol. 4611:
Ophthalmic Technologies XII
Fabrice Manns; Per G. Soederberg; Arthur Ho, Editor(s)

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