Treatment Guidelines Veterinary Procedures

Transscleral Diode Laser Protocol for Glaucoma There are two transscleral diode laser protocols used for glaucoma treatment in dogs: higher power with shorter duration; and lower power with longer duration. During treatment, both protocols create "pops" which are associated with boiling of intracellular water and aqueous. This indicates tissue disruption and reduced target protein coagulation. “Pops” may also increase post-operative inflammation. Treatment Parameters Higher Power/Shorter Duration These parameters are from the original treatment protocol. About 50% of veterinarians who perform...

Pigmented Tumors Iris melanomas and limbal melanomas are the most common tumors treated with the diode laser. These tumors are always treated “to effect”. Every tumor is different in size, thickness, and pigmentation. Thinner tumors normally don’t require as much power or exposure duration as thicker tumors. Pigmentation also varies from animal to animal, so darker lesions will not require as much power as lighter lesions. The treatment with the laser should cause the tumor to “shrink”. If there are tissue explosions, “popping” or smoke, the power is too high and must be lowered. If there is...

Treatment Parameters for Pigmented Tumors Using the Laser Indirect Ophthalmoscope (LIO): Since this is a "treatment-to-effect" procedure: The LIO is the next best option to the OMA. It is the most versatile tool because it can treat retinal disorders as well, but aligning the lesion to be treated with the examiner’s view through the opthalmoscope can be challenging. In most cases, the LIO is used without the 20D lens. This provides a 1.2 mm aerial image that works well for most tumors. If a larger spot size is needed, the surgeon can defocus the laser beam by moving closer or further away from...

Iris Cysts Iris cysts are pigmented fluid-filled sacks in the anterior chamber that may be free-floating or attached to the iris. If the cysts become large enough or numerous enough, they may severely inhibit vision and eliminate IOP. The cysts are usually very thin-walled and, in many cases, the pigmentation is mottled. The laser indirect ophthalmoscope (LIO) or operating microscope adapter (OMA) can be used to rupture iris cysts. Treatment Parameters Using the OMA and LIO Treatment with DioVet and Laser Indirect Ophthalmoscope 1. Set the power to maximum (OMA: 1200 mW; LIO: 1500 mW). 2. Set...

Delivery Devices Iris Melanoma Limbal Melanoma Pigmented Skin Lesions Iris Cysts Xscl Glaucoma Spot Size Converging/ Diverging from Tip Glaucoma Probe 0.3, 0.5, 0.8, 1.2, 6.88 in (with 175 Converging* 2 mm mm objective lens) 400 µm with 20D 16 in. (406 µm) lens; 1200 µm w/o lens DioPexy Probe Collimated for 1 mm then diverging Diverging, beam size 300 µm at 1 mm Delivery Device (1) Limited treatment area (2) Will work on heavily pigmented cysts (3) Non-contact procedure *Only converging systems can be used for transcorneal treatment of intraocular tumors. With a diverging beam, the laser energy...