Article

Chronic and acute analysis of optic nerve sheath fenestration with the free electron laser in monkeys†

  1. Karen M. Joos MD, PhD1,*,
  2. Louise A. Mawn MD1,
  3. Jin H. Shen PhD1,
  4. Vivien A. Casagrande PhD1,2

Article first published online: 3 JAN 2003

DOI: 10.1002/lsm.10146

Issue

Lasers in Surgery and Medicine

Lasers in Surgery and Medicine

Volume 32, Issue 1, pages 32–41, January 2003

Additional Information

How to Cite

Joos, K. M., Mawn, L. A., Shen, J. H. and Casagrande, V. A. (2003), Chronic and acute analysis of optic nerve sheath fenestration with the free electron laser in monkeys. Lasers Surg. Med., 32: 32–41. doi: 10.1002/lsm.10146

Author Information

  1. 1

    Department of Ophthalmology and Visual Sciences, Vanderbilt University, Nashville, Tennessee

  2. 2

    Departments of Cell and Developmental Biology and Psychology, Vanderbilt University, Nashville, Tennessee

*Department of Ophthalmology and Visual Sciences, 1215 21st Ave South, 8017 MCE, Nashville, TN 37232-8808.

  1. †

    This material is based on research sponsored by the Air Force Research Laboratory with the aid of NEI Core Grant P30-EY08126. The U.S. Government is authorized to reproduce and distribute reprints for Governmental purposes notwithstanding any copyright notation thereon. The views and conclusions contained herein are those of the authors and should not be interpreted as necessarily representing the official policies or endorsements, whether expressed or implied, of the Air Force Research Laboratory or the U.S. Government.

Publication History

  1. Issue published online: 3 JAN 2003
  2. Article first published online: 3 JAN 2003
  3. Manuscript Accepted: 6 NOV 2002

Funded by

  • Department of Defense Medical Free Electron Laser Program, Office of Naval Research. Grant Number: N00014-94-1023
  • Air Force Research Laboratory. Grant Number: F49620-01-1-0429
  • Research to Prevent Blindness, Inc., NY
  • National Eye Institute. Grant Number: P30-EY08126

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Keywords:

  • glial cell;
  • histology;
  • immunocytochemistry;
  • laser;
  • optic nerve;
  • surgery

Abstract

Background and Objectives

The Amide II wavelength (6.45 μm) produced by the free electron laser (FEL) can efficiently create an optic nerve sheath fenestration in rabbits. We wished to determine if it would be equally successful in macaque monkeys and to determine the histopathologic changes between traditional scissors or knife optic nerve sheath fenestration to FEL fenestration.

Study Design/Materials and Methods

Optic nerve sheath fenestration was performed using either the FEL (6.45 μm, 30 Hz, 2–3 mJ, 325-μm spot size) through a hollow waveguide probe in 12 eyes or with a scissors or a knife in 6 eyes. The monkeys survived 1 month with the fellow optic nerve operated acutely just prior to sacrifice. Optic nerves were evaluated histologically.

Results

Less tissue manipulation was required using the FEL surgical probe. Electroretinograms showed minimal or no change. Tissue responses using either method were similar following chronic or acute incisions. Mild upregulation of vimentin and glial fibrillary acid protein (GFAP) was seen in astrocytes adjacent to the fenestration, but no change in S100β was evident.

Conclusions

The FEL energy at 6.45 μm delivered through a hollow waveguide appears capable of efficiently and safely producing an optic nerve sheath fenestration in monkeys. This innovative surgical technique should be considered for human use. Lasers Surg. Med. 32:32–41,2003. © 2003 Wiley-Liss, Inc.

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