Photoacoustic injury and bone healing following 193nm excimer laser ablation.

The argon-fluoride excimer laser was investigated as a cutting-ablating tool for bone surgery. A total of 52 rats were divided into two experimental groups and two control groups. In one experimental group cortical bone defects were made; in another experimental group defects penetrating into the medullary space were performed. In the two control groups similar defects were achieved using water-cooled carbide burs. The rats were sacrificed on each of the 3, 7, 10, 20, 30, and 40 postoperative day. The cortical bone, the medullary space, and the extrabony tissue were examined by means of light microscopy. In both experimental groups, bone damage, represented by osteocyte destruction, extended to 1,050-1,450 microns ahead from the irradiated site, and bone healing was very much impaired. In the control groups no histological changes could be identified and bone healing appeared to be within normal limits. We believe this extensive bone damage, following 193 nm irradiation, to be a result of photoacoustic waves propagating in the bone following each pulse. In view of our results we feel that excimer lasers presently in use are not suitable for bone surgery. This problem of photoacoustic damage can be overcome in one of two ways: by designing a CW excimer laser or by reducing the pulse width to the picosecond regime.