Abstract

Erbium and holmium lasers are attractive for minimally invasive surgical applications as they operate at wavelengths where tissues exhibit strong absorption due to their water content and because these wavelengths are transmittable through optical fibers. In this study, the basic physical mechanisms underlying tissue ablation and the laser-induced tissue effects using pulsed Er:YSGG (2.79 /spl mu/m) and Ho:YAG (2.12 /spl mu/m) laser radiation are presented and compared, Q-switched (/spl tau/=40 ns, E/spl les/50 mJ) and free-running (/spl tau/=250 and 400 /spl mu/s) Er:YSGG (E=100 mJ) and Ho:YAG (E/spl les/1 J) laser energy was delivered in water via a 400-/spl mu/m fiber. The dimension and lifetime of the expanding and collapsing bubbles and the laser-induced pressure in water after each laser pulse were measured with fast-flash videography and time-resolved pressure measurements. Depending on the absorption coefficient, pulse energy, and pulse duration, three different regimes were distinguished: evaporation, tensile-stress-induced cavitation, and explosive vaporization. In vitro tissue effects, ablation depth, and extent of tissue damage on meniscus treated under water and on cornea treated in air were investigated and examined histologically. Er:YSGG radiation, due to its 100 times higher absorption than Ho:YAG radiation, exhibited a high tissue ablation efficiency with a relatively small zone of coagulated tissue (Q-switched 4-10 /spl mu/m, free-running less than 100 /spl mu/m), whereas the coagulated tissue zone was 300-1000 /spl mu/m after free-running and 100-120 /spl mu/m after Q-switched Ho:YAG laser impact.

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