Kroitzsch U, Laufer G, Egkher E, Wollenek G, Horvath R
Department of Accident Surgery II, University of Vienna, Austria.
Arch Orthop Trauma Surg. 1989;108(1):44-8. doi: 10.1007/BF00934157.
Excimer lasers have been demonstrated to provide a very precise and circumscribed ablation of synthetic polymers and biological tissues. We investigated in vitro the use of ultrashort pulsed ultraviolet excimer-laser energy for controlled removal of meniscus cartilage under the aspects of arthroscopic meniscectomy. A krypton-fluorine gas mixture was used to achieve laser emission of 248-nm wavelength. A total of 22 human menisci obtained either by operation or necropsy were irradiated over a range of energy fluence (2.15-3.07 J/cm2/pulse), repetition rates (5-20 Hz), and exposure time (15-60s). Ablation rates of 4.00-5.76 microns per pulse were obtained. Light-microscopic examinations demonstrated tissue ablation without any evidence of pathological changes associated with continuous-wave laser irradiation. Effects of laser energy were clearly limited to the target of the laser beam, and tissue removal proceeded without production of heat or smoke. Due to the lack of pathological alterations observed, excimer-laser irradiation of meniscus cartilage may prove to be advantageous for precisely cutting and removing menisci without injury to the surrounding normal tissue. Clinical application of excimer-laser irradiation includes the development of suitable fiberoptics and laser coupling, as well as modification of fiber tips.
准分子激光已被证明能对合成聚合物和生物组织进行非常精确且局限的消融。我们在体外研究了超短脉冲紫外准分子激光能量在关节镜半月板切除术方面用于可控去除半月板软骨的情况。使用氪氟混合气体实现波长为248纳米的激光发射。对通过手术或尸检获得的总共22个人类半月板在一系列能量通量（2.15 - 3.07焦耳/平方厘米/脉冲）、重复频率（5 - 20赫兹）和暴露时间（15 - 60秒）下进行照射。获得了每个脉冲4.00 - 5.76微米的消融速率。光学显微镜检查显示组织消融，没有任何与连续波激光照射相关的病理变化迹象。激光能量的作用明显局限于激光束的目标部位，组织去除过程中不产生热量或烟雾。由于未观察到病理改变，准分子激光照射半月板软骨可能被证明有利于精确切割和去除半月板而不损伤周围正常组织。准分子激光照射的临床应用包括开发合适的光纤和激光耦合以及对光纤尖端进行改进。
