Körber Michael, Fellinger Jakob, Fritsche Milan, Giese Andreas, Kostourou Konstantina, Kopf Daniel, Kottcke Manfred, Luciani Francesco, Schmidbauer Josef M, Wenk Jonathan, Braun Bernd
Applied Mathematics, Physics and Humanities, Nuremberg Institute of Technology, Nuremberg, Germany.
Paracelsus Medical University, Nuremberg, Germany.
Front Med (Lausanne). 2024 Feb 8;11:1345976. doi: 10.3389/fmed.2024.1345976. eCollection 2024.
This work demonstrates significant advantages in ophthalmic surgeries through the use of picosecond ultrashort laser pulses instead of state-of-the-art nanosecond laser pulses. These ultrashort lasers shall serve as universal tools more effectively combining advantages of high precision, low impact and economic advantages compared to existing instruments.
As samples, we used post-mortem porcine eyes on which we performed the experiments with both picosecond and nanosecond lasers. Performed surgeries were laser iridotomy, (post-) cataract treatment/capsulotomy and selective laser-trabeculoplasty. Pulse widths were between 12 ps and 220 ns with pulse energies between 30 μJ and 10 mJ at 532 nm and 1,064 nm. Additionally, we investigated accompanying shock waves, cavitation bubbles, and heat effects during the ablation processes.
For all surgeries, significant differences were observed between picosecond and nanosecond pulses: It was possible to scale the pulse energy down to 10 of microjoules rather than requiring millijoules, and resulting tissue ablations are much more precise, more deterministic and less frayed. The shock wave and cavitation bubble investigation revealed major differences in pressure between picosecond pulses (0.25 MPa, 50 μJ) and nanosecond pulses (37 MPa, 5 mJ). The heat input during ablation could be lowered by two orders of magnitude.
Picosecond ultrashort laser pulses show substantial benefits for several ophthalmic surgeries, with regard to ablation precision, shock wave generation and heat input. They are better than state-of-the-art ophthalmic nanosecond lasers in all aspects tested.
本研究表明,与现有的纳秒激光脉冲相比,使用皮秒超短激光脉冲在眼科手术中具有显著优势。这些超短激光应作为通用工具,能更有效地结合高精度、低损伤和经济优势。
我们使用死后猪眼作为样本,分别用皮秒激光和纳秒激光进行实验。实施的手术包括激光虹膜切开术、(后)白内障治疗/晶状体囊切开术和选择性激光小梁成形术。脉冲宽度在12皮秒至220纳秒之间,在532纳米和1064纳米波长下的脉冲能量在30微焦至10毫焦之间。此外,我们还研究了消融过程中伴随的冲击波、空化气泡和热效应。
对于所有手术,皮秒脉冲和纳秒脉冲之间均观察到显著差异:可以将脉冲能量降低至微焦耳级别而非毫焦耳级别,并且由此产生的组织消融更加精确、更具确定性且边缘更整齐。冲击波和空化气泡研究揭示了皮秒脉冲(0.25兆帕,50微焦)和纳秒脉冲(37兆帕,5毫焦)之间在压力上的重大差异。消融过程中的热输入可降低两个数量级。
皮秒超短激光脉冲在消融精度、冲击波产生和热输入方面,对多种眼科手术显示出显著优势。在所有测试方面,它们均优于现有的眼科纳秒激光。