Kermani O, Lubatschowski H, Asshauer T, Ertmer W, Lukin A, Ermakov B, Krieglstein G K
Universitätsaugenklinik zu Köln, Germany.
Lasers Surg Med. 1993;13(5):537-42. doi: 10.1002/lsm.1900130507.
Ablative infrared lasers either show poor transmission in optical fibers (Er:YAG: 2.94 microns; ErCr:YSGG: 2.79 microns or are characterized by potential relevant thermal side effects (Ho:YAG: 2.1 microns). The CTE:YAG laser (Cr,Tm, Er doted YAG) emits radiation at a wavelength of 2.69 microns. Efficiently high optical fiber transmission is accomplished (attenuation: < 8db/m for Low-Hydroxy-Fused-Silica (LHFS): 0.3 ppm). Since the laser can easily be run in the Q-switch mode (pulse duration: 0.5-2.5 microseconds) thermal side effects of tissue interaction were expected to be low. Laser tissue interaction was studied on soft (porcine and human cornea), as well as on hard (human dental) tissue. Histological and micromorphological examinations were performed by light microscopy and scanning electron microscopy. It was found that ablation rates in corneal tissue increased from 5 to 90 microns/pulse with increasing laser fluences (5.5-20 J/cm2). Collateral thermal damage reached as far as 20 +/- 5 microns, and was higher (up to 50 microns) when craters where processed in the contact mode using LHFS-optical fibers. In comparison to soft tissue ablation, hard dental tissue ablation showed very little increase of ablation rate (1-3 microns/pulse) when higher fluences were applied. In dental tissue processing, the ablative effect was accompanied by a luminescence, indicating the presence of plasma. We conclude that the presented CTE:YAG laser can be considered as an effective tool for a variety of laser surgical applications where high power optical fiber delivery is required and where strong thermal side effects are not desired.
剥脱性红外激光要么在光纤中传输性较差(铒钇铝石榴石激光:波长2.94微米;铒铬钇钪镓石榴石激光:波长2.79微米),要么存在潜在的相关热副作用(钬钇铝石榴石激光:波长2.1微米)。铬、铥、铒掺杂钇铝石榴石(CTE:YAG)激光发射波长为2.69微米的辐射。实现了高效的光纤传输(对于低羟基熔凝石英(LHFS),衰减:<8分贝/米;羟基含量:0.3 ppm)。由于该激光能够轻松以调Q模式运行(脉冲持续时间:0.5 - 2.5微秒),预计组织相互作用的热副作用较低。对软组织(猪和人角膜)以及硬组织(人牙)进行了激光与组织相互作用的研究。通过光学显微镜和扫描电子显微镜进行了组织学和微观形态学检查。结果发现,随着激光能量密度增加(5.5 - 20焦/平方厘米),角膜组织的消融速率从5微米/脉冲增加到90微米/脉冲。旁侧热损伤可达20±5微米,当使用LHFS光纤以接触模式处理凹坑时,旁侧热损伤更高(可达50微米)。与软组织消融相比,施加更高能量密度时,硬牙组织消融的消融速率增加很少(1 - 3微米/脉冲)。在牙组织处理中,消融效应伴随着发光现象,表明存在等离子体。我们得出结论,所介绍的CTE:YAG激光可被视为一种有效的工具,适用于各种需要高功率光纤传输且不希望有强烈热副作用的激光手术应用。