Abstract
Cerebral lesions made by focal neodymium: yttrium-aluminum-garnet (Nd: YAG) laser irradiation of the rat forebrain were studied in adult Wistar rats. For the analysis of time-dependent changes, the brains of 28 animals were irradiated with a constant energy density of 461 J/cm2. In this series, survival time ranged from 0.5 hours to 80 days. Immediately after irradiation, a circular lesion appeared on the surface of the brain. This lesion was surrounded by an edematous area intensively stained with Evans blue. At energy levels higher than 30 J, this circular edema contained numerous thrombosed vessels. Histopathologically, the lesion consisted of three distinct zones: the central coagulation necrosis was surrounded by a zone of delayed colliquation necrosis and by perifocal edema. At approximately 80 days after irradiation, the resulting cortical defect was covered by a pial membrane. Edematous changes of the brain cortex and the adjacent white matter were observed as early as 1 hour after irradiation. Within 16 hours, the perifocal edema spread over the white matter of both hemispheres, and it had disappeared by the 5th day after irradiation. In a second experiment, the energy density varied from 231 to 3077 J/cm2. This series consisted of 84 animals that were allowed to survive 48 hours. The size of the lesion depended on the level of energy applied, but the depth of the lesion varied less than the diameter at the brain surface. The depth ranged from 1.3 mm at 20 J to 3.1 mm at 140 J, and the diameter of the lesion at the brain surface varied from 1.3 mm at 15 J to 5.8 mm at 140 J. The results obtained suggest that the Nd: YAG laser can be used for tumor coagulation with minimal risk of adverse effects on the adjacent brain.
Effects of topical Nepafenac and Fluorometholone on macular thickness after Neodymium: yttrium-aluminum-garnet (Nd: YAG) laser posterior capsulotomy
