Department of Ophthalmology, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea.
The Research Institute of Natural Science and Department of Physics Education, Gyeongsang National University, Jinju, Korea.
Transl Vis Sci Technol. 2022 May 2;11(5):2. doi: 10.1167/tvst.11.5.2.
In femtosecond laser-assisted cataract surgery (FLACS), capsulorhexis can be performed with an ophthalmic viscosurgical device (OVD) filled in the anterior chamber. We aimed to investigate changes in the laser properties in various optical aspects, such as focal shifting, reflection, and absorption associated with OVD.
Simulation was achieved by calculating the laser power attenuation due to reflection and spot size change using the Gullstrand eye model. Additionally, we calculated the absorption coefficient by measuring the laser power passing through the OVD with a laser meter and evaluated the effect of absorption by the OVD.
In our simulation, power attenuation due to reflection was a maximum of 0.07%, and power attenuation was 0.08% even when considering the change according to the incident angle. Power attenuation due to the change of the spot size at the focus was 0.005%. Owing to the absorption of the OVD, a power increase of up to 13.5% was required for an anterior chamber depth of 3.0 mm to obtain the same effect as the aqueous humor.
The main reason for laser power attenuation associated with OVD was laser absorption through the OVD, and could also be caused by laser cavitation bubbles. To complete a safe capsulotomy during FLACS, the laser power should be increased appropriately, considering the absorption by the OVD in the anterior chamber.
The study results can be applied to calculate the optimal femtosecond laser energy to achieve complete capsulotomy during FLACS in the presence of anterior chamber OVD.
在飞秒激光辅助白内障手术（FLACS）中，可以在前房内填充眼科黏弹剂（OVD）来进行囊膜环形撕囊。我们旨在研究与 OVD 相关的各种光学方面的激光特性变化，例如焦点偏移、反射和吸收。
通过使用古尔斯特兰德眼模型计算由于反射和光斑尺寸变化导致的激光功率衰减来进行模拟。此外，我们通过使用激光计测量通过 OVD 的激光功率来计算吸收系数，并评估 OVD 的吸收效果。
在我们的模拟中，由于反射导致的功率衰减最大为 0.07%，即使考虑到入射角的变化，功率衰减也只有 0.08%。由于焦点处光斑尺寸的变化导致的功率衰减为 0.005%。由于 OVD 的吸收，在前房深度为 3.0mm 时，需要增加高达 13.5%的功率才能获得与房水相同的效果。
与 OVD 相关的激光功率衰减的主要原因是激光通过 OVD 被吸收，也可能是由于激光空化气泡引起的。为了在 FLACS 中安全地进行囊膜切开术，应考虑到前房 OVD 的吸收，适当增加激光功率。
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