Novel application for endoscopy: A subretinal approach.

Hugo Quiroz-Mercado, M. Turati, S. L. Guerrero-Naranjo,
F.G.J. Koch, L.-O. Hattenbach (Mexico/Frankfurt/M.)

Actually a definitive treatment for CNV hasn’t been established.Our objectives are to develop a direct treatment of CNV by subretinal approach using a high resolution endoscope to guide treatment avoiding thermal retinal damage and preventing massive destruction of the RPE and choroid. Even with PDT, macular translocation and CNV extraction, some selected cases can be treated by endoscopy. So far laser therapy is the most accepted method to make new vessels regress in retinal pathology.
Our main goal is to make the new vessels regress and to eliminate the fibrovascular tissue. We base our work in our previous scientific experience using the Erbium-YAG, 532nm and 810 nm lasers, performing regression of the new vessels and a diminishment of the fibrotic tissue in patients with CNV.
One of the challenges to perform the pigment epithelium endoscopic laser surgery (PEELS) by a high resolution endoscopy is to create an adequate working space between the retina and the RPE. In our experience we have used PFO and Healon to create the working space. In such studies so far we have treated 24 patients (15 with PFO and 9 with Healon). The Erbium-YAG laser is an excellent tool that provides a fine cut of the membranes with minimal coagulation. Future research is needed to find which is the best substance to create the working space and to determine which is the best energy for vascular coagulation, ablation of the fibrotic tissue and stimulation of the RPE.

Back