Abstract: The THC:YAG laser was used to create 93 thermal sclerostomies ab externo in 81 glaucomatous eyes of 76 patients. This holmium laser is a long-pulsed, compact, self-contained, solid-state laser operating in the near infrared. A 1-mm conjunctival stab incision was made 5-15 mm from the sclerostomy site to allow entry of a specially designed 22-gauge optic probe that delivers energy at a right angle to the long axis of the fiber. Pulse energies of 80 mJ to 120 mJ were used with a repetition rate of 5 pulses per second. Total energy levels to produce full-thickness sclerostomies ranged from 1.4 to 7.2 J. Seventy-eight eyes received the antimetabolite 5-fluorouracil. Success was defined as postoperative intraocular pressure $APLS@22 mmHg, or a $APGR@30% reduction in intraocular pressure if preoperative pressure was $APLS@22 mmHg. Estimated probability of success was 0.66 at 12 months and 0.57 at both 24 months and 30 months. Mean intraocular pressure of successful cases was 12.7 mmHg, 12.9 mmHg, and 13.0 mmHg at 12, 24, and 30 months, respectively. This is the 30-month report of an on-going clinical trial. !9
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