Optical properties of human sclera, and their consequences for transscleral laser applications.

The spectral dependence of the optical properties of human sclera adjacent to the limbus was investigated and related to the potentials of transscleral photocoagulation. The total transmission, absorption, and reflection, as well as the angular distribution of the transmitted and reflected light were measured at five laser wavelengths (442 nm, 514 nm, 633 nm, 804 nm, and 1,064 nm), both for noncontact and contact applications. Absorption and scattering coefficients were determined using the Kubelka-Munk model for light propagation through a scattering tissue. The scleral transmission is only 6% at 442 nm but increases to 35% at 804 nm and to 53% at 1,064 nm. The absorption is high at short wavelengths with 40% at 442 nm but it is only 6% at 804 nm and 1,064 nm. The reflection is generally higher than 40% and shows little wavelength dependence. The transmitted light is scattered diffusely at short wavelengths, but at 804 nm and 1,064 nm it exhibits a fairly narrow angular distribution in forward direction. Fiber contact leads to an increase of transmission, with a factor of 3.5 at 442 nm, of 2.0 at 804 nm, and 1.5 at 1,064 nm. Our results indicate that the diode laser (804 nm) and the Nd:YAG laser (1,064 nm) with contact delivery are best suited for transscleral photocoagulation.