Excimer laser ablation of the cornea and lens. Experimental studies.

The pulsed ultraviolet excimer laser has been used to produce tissue ablation with a high degree of precision and with minimal thermal damage to adjacent structures. In comparative studies of excimer laser ablation of the cornea and crystalline lens using 193 nm and 248 nm radiation, threshold fluence for corneal and lens ablation was higher at 248 nm than at 193 nm. Ablation of corneal stroma at 193 nm produced the most precise cuts. When examined by transmission electron microscopy, a narrow zone of damaged tissue (0.1 to 0.3 micron) was seen immediately adjacent to the tissue removed by the laser. Ablation with 248 nm radiation produced incisions with ragged edges and with a wider and more severe zone of damage in adjacent stroma. Ultraviolet spectral transmission studies of the corneal stroma showed that absorption is 10 times greater at 193 nm than at 248 nm. The excimer laser was effective in producing well controlled ablation of the crystalline lens in vitro, with effects parallel to those seen in the cornea.