Proliferative vitreoretinopathy often requires sophisticated posterior segment surgery. Closed system pars plana vitrectomy, retinal membrane stripping, fluid-air exchange, open-sky vitrectomy, and photocoagulation have been suggested as approaches to its management. Removal of the gel-like vitreous is often complicated by relatively tough membraneous strands attached to the retina. Removal of the vitreous and its associated membranes from the eye is a difficult and delicate surgical procedure, and mechanical disturbances of these strands will tear the retina with subsequent vision deficits. There is a clear need for a non-mechanical approach to this delicate surgery. We propose the use of the Er: YAG laser operating at the 2.94 micron wavelength for dissecting vitreal membranes. This wavelength is at the peak of tissue and water absorption and would, therefore, be an ideal tool for ablating these delicate structures and would have a highly confined thermal response limiting damage to underlying structures. The purpose of our research is to develop a small, portable Er: YAG laser with a sapphire fiber optic delivery system for performing vitreoretinal surgery.
