Ophthalmic applications of femtosecond lasers

Ron M. Kurtz M.D.; Greg J. R. Spooner; Karin R. Sletten M.D.; Kimberly G. Yen M.D.; Samir I. Sayegh M.D.; Frieder H. Loesel; Christopher Horvath; HsiaoHua Liu; Victor Elner M.D.; Delia Cabrera; Marie-Helene Muenier; Zachary S. Sacks; Tibor Juhasz; Doug L. Miller; A. Roy Williams

doi:10.1117/12.351821

4 June 1999 Ophthalmic applications of femtosecond lasers

Ron M. Kurtz M.D., Greg J. R. Spooner, Karin R. Sletten M.D., Kimberly G. Yen M.D., Samir I. Sayegh M.D., Frieder H. Loesel, Christopher Horvath, HsiaoHua Liu, Victor Elner M.D., Delia Cabrera, Marie-Helene Muenier, Zachary S. Sacks, Tibor Juhasz, Doug L. Miller, A. Roy Williams

Author Affiliations +

Proceedings Volume 3616, Commercial and Biomedical Applications of Ultrafast Lasers; (1999) https://doi.org/10.1117/12.351821
Event: Optoelectronics '99 - Integrated Optoelectronic Devices, 1999, San Jose, CA, United States

Abstract

We investigated three potential femtosecond laser ophthalmic procedures: intrastromal refractive surgery, transcleral photodisruptive glaucoma surgery and photodisruptive ultrasonic lens surgery. A highly reliable, all-solid-state system was used to investigate tissue effects and demonstrate clinical practicality. Compared with longer duration pulses, femtosecond laser-tissue interactions are characterized by smaller and more deterministic photodisruptive energy thresholds, smaller shock wave and cavitation bubble sizes. Scanning a 5 (mu) spot below the target tissue surface produced contiguous tissue effects. Various scanning patterns were used to evaluate the efficacy, safety, and stability of three intrastromal refractive procedures in animal eyes: corneal flap cutting, keratomileusis, and intrastromal vision correction (IVC). Superior dissection and surface quality results were obtained for the lamellar procedures. IVC in rabbits revealed consistent, stable pachymetric changes, without significant inflammation or corneal transparency degradation. Transcleral photodisruption was evaluated as a noninvasive method for creating partial thickness scleral channels to reduce elevated intraocular pressure associated with glaucoma. Photodisruption at the internal scleral surface was demonstrated by focusing through tissue in vitro without collateral damage. Femtosecond photodisruptions nucleated ultrasonically driven cavitation to demonstrate non-invasive destruction of in vitro lens tissue. We conclude that femtosecond lasers may enable practical novel ophthalmic procedures, offering advantages over current techniques.

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Ron M. Kurtz M.D., Greg J. R. Spooner, Karin R. Sletten M.D., Kimberly G. Yen M.D., Samir I. Sayegh M.D., Frieder H. Loesel, Christopher Horvath, HsiaoHua Liu, Victor Elner M.D., Delia Cabrera, Marie-Helene Muenier, Zachary S. Sacks, Tibor Juhasz, Doug L. Miller, and A. Roy Williams "Ophthalmic applications of femtosecond lasers", Proc. SPIE 3616, Commercial and Biomedical Applications of Ultrafast Lasers, (4 June 1999); https://doi.org/10.1117/12.351821

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