Birngruber R, Hefetz Y, Roider J, Schmidt U, Fujimoto J G, Puliafito C A, Vogel A
Medizinisches Laserzentrum Lübeck, Medizinischen Universität zu Lübeck.
Ophthalmologe. 1993 Aug;90(4):387-90.
Laser photodisruption is a routinely performed clinical procedure in intraocular microsurgery of post-cataract membranes, anterior synechies and iridectomies. Damage ranges of several millimeters in diameter, however, limit the use of nanosecond photodisruption close to delicate structures, e.g., in the posterior vitreous. Multiple ps-laser pulses of about 100 microJ pulse energy were used to produce disruptive effects in the anterior lens capsule in rabbit eyes in vivo. Ophthalmoscopical and morphological investigations of these effects were compared with those of minimal ns-disruptions. The direct tissue separation effects as well as the collateral damage zones are about one order of magnitude smaller if ps-laser pulses are used. Minimal sizes of disruptive effects are about 50 microns to 150 microns and 500 microns to 1000 microns for ps- and ns-pulses, respectively. The substantial improvement of spatial confinement of ps-photodisruption enables increased precision of intraocular laser microsurgery and opens up new areas of clinical application in structures like the cornea, anterior chamber angle, and crystalline lens.
激光光破裂是白内障后膜、虹膜前粘连和虹膜切除术等眼内显微手术中常规实施的临床操作。然而,直径达数毫米的损伤范围限制了纳秒级光破裂在靠近精细结构(如后玻璃体)处的应用。在兔眼活体的晶状体前囊膜中,使用多个脉冲能量约为100微焦的皮秒激光脉冲来产生破坏作用。对这些效应的检眼镜检查和形态学研究与最小纳秒级破裂的效应进行了比较。如果使用皮秒激光脉冲,直接组织分离效应以及附带损伤区域大约小一个数量级。皮秒和纳秒脉冲产生破坏效应的最小尺寸分别约为50微米至150微米和500微米至1000微米。皮秒光破裂在空间限制方面的显著改善提高了眼内激光显微手术的精度,并为角膜、前房角和晶状体等结构开辟了新的临床应用领域。