Microvitreoretinal blade, excimer laser show efficacy for performing optic neurotomy

Performing optic neurotomy with a microvitreoretinal blade may be an effective, relatively complication-free method of performing scleral outlet relaxation, according to a study involving cadaver eyes. "This preliminary study also demonstrates that the excimer laser can make non-mechanical cuts with relative ease and reliability," the study authors noted.

Masoud Soheilian, MD, and colleagues evaluated the histopathologic results of 14 cadaver eyes that underwent optic neurotomies performed using either a 20-gauge microvitreoretinal blade (11 eyes) or an excimer laser (three eyes).

"No eyes in the [microvitreoretinal] group had scleral macroscopic or microscopic perforation and there was no injury to the central retinal vein or artery," the authors said.

In 10 eyes, the distance between the neurotomy site and the central retinal vessels was between 50 µm and 500 µm at all histologic levels; the distance was approximately 10 µm in two histologic sections and 200 µm in a third section for one eye, according to the study.

The researchers reported intraneural hemorrhages in 11% of eyes.

"Neurotomy was successful in two of three eyes with the excimer laser and no neurotomy was evident on sectioning in the third eye due to cloudy media," the authors reported.

The study is published in the January/February issue of Ophthalmic Surgery Lasers and Imaging.