Background:
The recent introduction of 445 nm blue laser to office-based laryngology presents potential advantages. These include a desirable combination of cutting and photoangiolytic qualities and ...a lightweight, shock-resistant design. Despite its increasing use, current evidence is limited to experimental data and case reports.
Objectives:
The authors present a case series and overview of office blue laser transnasal flexible laser surgery (TNFLS), considering indications, patient selection, safety, technique, and surgical outcomes. We also review the safety and relevance of TNFLS to the ongoing coronavirus pandemic.
Methods:
Retrospective case series and narrative review. Our primary outcome measure was preoperative and postoperative Voice Handicap Index (VHI-10) score. Complications were documented by nature and severity.
Results:
Thirty-six cases of office blue laser TNFLS were performed. A statistically significant improvement in VHI-10 score was demonstrated in cases of recurrent respiratory papillomatosis (RRP) and benign laryngeal lesions causing dysphonia (P < 0.01 and 0.045). Blue laser also proved effective in assisting office biopsy procedures. A minor and self-limiting complication was reported.
Conclusions:
Office blue laser TNFLS is safe and effective in the treatment of RRP and a range of benign laryngeal lesions. Future research should compare the efficacy and safety of blue laser with potassium titanyl phosphate laser in office-based treatment of these conditions. Further assessment of the cutting qualities of blue laser, initially in the theater environment, is necessary to refine our understanding of future applications.
Цель. Повысить эффективность и безопасность лентикулярной хирургии по типу SMILE в коррекции миопии разной степени на основе применения низкоэнергетических лазерных параметров. Материал и методы. В ...исследовании проведен сравнительный анализ данных 193 пациентов (288 глаз), оперированных по поводу миопии разной степени в ряде случаев с миопическим астигматизмом по технологии SMILE с применением разных уровней энергии фемтосекундного лазера (ФСЛ) от 130 до 1 50 нДж. Параметры анализировали в 1 -e сутки и через 1 неделю, 1,3, 6 и 12 месяцев после операции с оценкой некорригированной остроты зрения, качества жизни (опросник QIRC), общих аберраций волнового фронта роговицы (RMS), денситометрии и пахиметрии. Результаты. Поданным визометрии, оценки качества жизни, показателям RMS, денситометрии и пахиметрии, наилучшие функциональные результаты получены в подгруппах с миопией слабой и средней степени в 1 -e сутки после SMILE при применении уровня энергии в диапазоне 130 нДж. А в подгруппах с высокой степенью миопии при использовании уровня энергии в диапазоне 140 нДж прямого влияния энергии на другие показатели не выявлено. Заключение. По итогам исследования установлено, что проведение коррекции миопической аномалии рефракции по технологии SMILE с уровнем энергии ФСЛ в диапазоне 130-140 нДж по своей результативности в 1-е сутки после операции превосходит применявшие ранее уровни энергии (150 нДж) по качеству восстановления зрительных функций и не оказывает отрицательного влияния на другие параметры роговицы.
Bilateral vocal fold paralysis can be a disabling condition with adverse impact on quality of life. Various glottal widening procedures to secure the airway have been described. These include total ...or partial arytenoidectomy with or without reinnervation, cordotomy, arytenoidopexy, and others. A review of the literature shows one case of office-based partial arytenoidectomy that was performed successfully using the thulium laser but no other in-office procedures for the treatment of bilateral vocal fold paralysis.
Retrospective case series with literature review
This report presents two patients with bilateral vocal fold paralysis who underwent office-based blue laser posterior cordectomy. The blue laser is a new photoangiolytic laser (wavelength of 445 nm) with good hemostatic and cutting properties. The surgical technique of office-based posterior cordectomy using the blue laser is described with a review of the literature on arytenoidectomy/posterior cordectomy.
Both procedures were well tolerated and patients showed marked improvement in breathing manifested by an increase in glottal gap on laryngeal examination with no worsening in voice quality. Long-term follow-up showed no interval changes in both cases.
The authors of this manuscript advocate office-based posterior cordectomy using the laser in patients who are at high risk for general anesthesia or who refuse to go to the operating room, and potentially for other patients.
The data that support the findings of this study are available from the corresponding author upon reasonable request.
The objective is to study vocal outcomes following Laser Assisted Sulcus Release (LASR), having documented the length and depth of the sulcus intraoperatively. LASR performed for superficial and deep ...sulci were included.
Retrospective, Observational
The preoperative and 3-month postoperative and post voice-therapy VHI, GRBAS, MPT, FO and stroboscopy findings were noted retrospectively from our voice clinic records of LASR patients. Intraoperative sulci length and depth details were noted from records. Patients with coexisting lesions, surgically tackled, were excluded.
In a total of 14 patients, 21 superficial sulci and 8 deep sulci were operated by LASR. The average preoperative VHI improved from 25.3 to 9.9, GRBAS from 10.6 to 3.5 and MPT from 7.6 to 12.3 seconds. The preoperative average FO was 235.9 Hz in 12 patients (no pick-up in 2) with a post-operative 248.4 Hz. Using the Mann – Whitney U test we found a statistically significant improvement in MPT, VHI and GRBAS of the patients. There was no significant improvement in the F0 of the patients. There was no postoperative voice deterioration in any patient.
A preoperative phonatory gap was found in all patients, which postoperatively was absent in 10, markedly decreased in 3, present in 1 with stroboscopy revealing an improvement in mucosal wave amplitude in 13 patients.
In 4 patients with deep bilateral sulci where the LASR had been ligament deep, VHI improved from 26 to 13.3, GRBAS from 12 to 6.5 and MPT from 4.3 to 9.5 seconds. Using the Mann Whitney U test all three parameters were significantly improved.
A statistically significant vocal improvement in VHI, GRBAS and MPT was observed at 3 months, in superficial and deep sulci, operated by LASR.
LASR is a simple, quick and easily replicable surgery. Larger multi-centric studies with long-term follow-up are recommended.
Level 4
For ophthalmologists who are already using femtosecond lasers as well as those just starting out who are looking for the definitive reference manual, Femtosecond Lasers in Cornea and Lens Surgery is ...a comprehensive, cutting-edge guide to this technology that features a robust supplemental website with nearly 40 surgical videos.
Background . Accommodation disorders in children with hypermetropia is one of the main factors in emmetropization disorders and maintenance of image defocusing. The most severe changes ...in accommodation are observed in children with anisometropia and hyperopia. The aim of the work . To evaluate the changes in the accommodative function of the eye in children with hyperopia, amblyopia, who underwent refractive laser surgery (RLS), as well as in children with spectacle and contact lens correction in combination with pleoptic treatment. Methods and materials . Group 1 consisted of 30 children after RLS; group 2 consisted of 29 children who had spectacle correction; group 3 consisted of 26 children who had soft contact lens correction; all children received pleoptic treatment. Clinical examination included the analysis of objective reserves of relative accommodation (RRA) and objective accommodative response (OAR) with an open field autorefractometer, and the results of accommodation measurement. Results . In 1.5 years, statistically significant changes were observed in the coefficient of accommodation response (CAR) of the amblyopic eye between the groups 1 and 2 – 0.12 ± 0.02 and 0.00 ± 0.1 relative units, respectively (p = 0.01). Similar statistically significant changes were obtained in OAR and objective RRA of the amblyopic eye. OAR in the group 1 was –2.1 ± 0.67 dpt, in the group 2 – –1.38 ± 0.19 dpt (p = 0.01). At the end of the observation, the OAR in the group 1 was –2.1 ± 0.67 dpt, the objective RRA – –2.1 ± 0.67 dpt; in the group 2 the OAR was –1.38 ± 0.19 dpt (p = 0.01), the objective RRA – –1.38 ± 0.19 dpt (p = 0.01). There were no statistically significant changes in these parameters of the amblyopic eye between the groups 1 and 3. Conclusion . There was an improvement of accommodation disorders in children with anisometropia, hyperopia and amblyopia after refractive laser surgery and in children with contact lens correction. Due to a decrease in the refractive indices of the amblyopic eye, the values of CAR, OAR and objective RRA after refractive laser surgery tended to be closer to the normal values.
Цель. Представить технологию проведения предварительной радиальной ИАГ-лазерной факофрагментации в хирургическом лечении катаракты. Материал и методы. Технология предварительной радиальной ...ИАГ-лазерной факофрагментации применяется в Калужском филиале МНТК «Микрохирургия глаза» им. акад. С.Н. Федорова с 2016 г. Суть технологии заключается в неинвазивном эндокапсулярном формировании радиальных разломов ядра катарактального хрусталика для последующей его фрагментации в ходе ультразвуковой факоэмульсификации катаракты (ФЭК). Суммарное количество импульсов составляет от 95 до 150. Результаты. За 2016-2023 гг. в Калужском филиале МНТК «Микрохирургия глаза» им. акад. С.Н. Федорова предварительная радиальная ИАГ-лазерная факофрагментация выполнена на 9468 глазах с катарактой 2-4-й степеней плотности. После ИАГ-лазерной ной фрагментации ядра катарактального хрусталика определяется его радиальное расслоение по типу «снежинки», которая состоит из 3 слоев и «лепестков», отходящих от кавитационных пузырьков, четко очерчивающих ядро. Клинико-функциональное состояние глаз после предварительной ИАГ-лазерной факофрагментации свидетельствовало об отсутствии реактивного воспаления со стороны переднего и заднего отрезков глаза, что подтверждалось данными биомикроскопии и ультразвукового офтальмосканирования. Заключение. Технология предварительной радиальной ИАГ-лазерной факофрагментации - безопасный и эффективный способ, позволяющий достичь равномерного расслоения хрусталиковых волокон по сформированным зонам фрагментации, которые соответствуют последующим зонам разлома ядра при проведении этапа фрагментации ядра в ходе ультразвуковой ФЭК.
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