Experimental transconjunctival diode laser retinal photocoagulation through silicone scleral exoplants

S. K. Nanda and D. P. Han
Department of Ophthalmology, Eye Institute, Medical College of Wisconsin, Milwaukee, USA.

OBJECTIVE: To study the feasibility of inducing a chorioretinal lesion under a previously placed scleral buckle by experimental transconjunctival diode laser photocoagulation. METHODS: We performed transconjunctival diode laser photocoagulation in the peripheral retinas of seven pigmented rabbit eyes with a silicone exoplant (No. 42 band or No. 276 tire) and seven eyes without an exoplant. Each eye received burns with an intensity of grades 1 to 3 in different quadrants at varying power levels, with a 0.5-second duration and 650-micron spot size. Eyes were enucleated for histopathologic studies 1 day and 1 week after treatment. RESULTS: Although the irradiance emitted through the No. 42 band and the No. 276 tire was attenuated by 17% and 23%, respectively, the range of threshold powers needed to produce grades 1 to 3 burns was similar between eyes with and without a silicone exoplant. At 1 day, full-thickness coagulative necrosis was observed in all lesions, except that the ganglion cell layer and inner nuclear layer were preserved in two of four grade 1 burns and the ganglion cell layer was intact in one of six grade 2 burns. Inner scleral changes were noted acutely in three of five grade 3 lesions. At 1 week, burns of all intensity grades showed a full-thickness atrophic chorioretinal lesion with inner scleral changes. CONCLUSIONS: Experimental transconjunctival diode laser photocoagulation through hard silicone elements reproducibly created a chorioretinal lesion with histopathologic findings similar to those of lesions obtained without these elements. Although retinal photocoagulative effects were prominent, inner scleral abnormalities were also observed histologically.