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Biomedical subjects

J B Wise

Publications and source records attributed to J B Wise.

6 recordsLinked to original sources
PubMed1987

Low-energy linear-incision neodymium: YAG laser iridotomy versus linear-incision argon laser iridotomy. A prospective clinical investigation.

When the Q-switched neodymium: YAG (Nd: YAG) laser is focused through the Wise 103-diopter (D) iridotomy-sphincterotomy lens (103-D lens) at low energy levels, the peripheral iris fibers can be cut individually across the iris tension lines to produce large iridotomies of controllable size. Thirty patients had linear-incision Nd:YAG laser iridotomy in one eye and linear-incision argon laser iridotomy in the other. Two-hour post-laser IOP rises averaged 7.33 mmHg for the Nd:YAG laser and 8.64 mmHg for the argon laser. The argon laser produced lens burns in 9 of 30 eyes, including 7 of 9 blue eyes. No lens damage occurred with the Nd:YAG laser. No corneal or retinal damage was seen with either laser. Local oozing of blood inhibited optical breakdown and required a pause before completion in 5 of 30 eyes with Nd:YAG iridotomy, including 4 of 6 dark brown thick irides. Because the iris fibers must be cut by direct contact with the laser plasma, serial cutting of iris fibers by multiple low-energy plasmas is safer than a single-shot, high-power plasma occupying the full thickness of the iris. Because it is effective and because it avoids the hazards of argon laser iridotomy and of high-power Nd:YAG laser iridotomy, linear incision Nd:YAG laser iridotomy is recommended as the safest method of iridotomy.

Argon↗
PubMed1987

Large iridotomies by the linear incision technique using the neodymium:YAG laser at low energy levels. A study using cynomolgus monkeys.

Multiple Q-switched neodymium:YAG (Nd:YAG) laser impacts at energy levels of 1.0 to 1.7 mJ, focused on the iris through the 103-diopter (D) iridotomy-sphincterotomy lens, were applied back and forth in a line across the radial fibers of the mid-peripheral iris in eyes of the cynomolgus monkey (Macaca fasicularis) to produce large iridotomies of controllable size. Oozing of blood was minimal and no lens capsule damage occurred. These iridotomies showed less iris concussion damage than did conventional Nd:YAG laser iridotomies made by directing high-energy laser shots through the Abraham lens upon a single iris spot.

Animals↗
PubMed1987

Ten year results of laser trabeculoplasty. Does the laser avoid glaucoma surgery or merely defer it?

The first 150 consecutive phakic eyes from 113 patients aged 40 years or more treated with laser trabeculoplasty were evaluated. Twenty-four patients (37 eyes) have died, two eyes developed spontaneous rubeosis, and one patient (one eye) was not available, leaving 110 eyes with a 6 to 10 years follow-up. Of the 37 eyes of dead patients (average age 80 years), only one eye had filtering surgery, and 33 of the other 36 eyes had a last recorded intraocular pressure of less than 21 mm Hg. Of the 110 eyes of living patients followed for 6 years, 33 had filtering surgery and 62 eyes (56 per cent) had an intraocular pressure of less than 21 mm Hg. Of 10 eyes followed for 10 years, eight had intraocular pressures less than 23 mm Hg, seven had pressures less than 21 mm Hg, and two had had filtering surgery. Eyes with advanced disc damage at the time of trabeculoplasty had a 51 per cent rate of later glaucoma surgery, while eyes with a cup/disc ratio less than 0.9 at trabeculoplasty had a glaucoma surgery rate of 16 per cent. Eyes of non-white patients did as well as eyes of white patients. Computer analysis of over 1,700 eyes with two-year follow-up indicated better long-term control when 100 or more laser burns were used for trabeculoplasty. Laser trabeculoplasty can defer surgery for the remaining lifespan in elderly patients, and has controlled primary open-angle glaucoma for over 10 years, but later glaucoma surgery is often required in eyes with far advanced glaucoma damage.

Adult↗
PubMed1986

A high-efficiency laser iridotomy-sphincterotomy lens.

A new laser iridotomy-sphincterotomy contact lens, bearing a 103-diopter optical button decentered 2.5 mm, gives the smallest iris focal spot and highest iris energy density practicably obtainable with a single optical glass refracting surface placed upon a thin Goldmann-type contact lens. By increasing iris energy density to a level 7.79 times greater than that from a plano contact lens and 2.92 times greater than that from the Abraham lens, the lens increases the iris burn temperature level above the threshold level for evaporative pyrolysis, even at exposures of 0.01 and 0.02 second, thus facilitating argon laser iridotomy and iris sphincterotomy by the linear incision method. Corneal and retinal energy exposures are greatly reduced. Used with the Nd-YAG laser, the lens increases efficiency for iridotomy and for division of vitreous bands in the anterior chamber.

Contact Lenses↗