Photodisruption cristallinienne par laser femtoseconde : étude expérimentale

Abstract

The aim of this study was to analyze the interactions during femtosecond (fs) laser photodisruption in ex vivo porcine crystalline lenses and to study the parameters for laser interaction optimization. An experimental femtosecond laser was used. The laser characteristics were: 1030 nm wavelength; pulse duration, 400 fs; and numerical aperture, 0.13. Specific software was created to custom and monitor any type of photoablation pattern for treatment purposes. Porcine crystalline lenses were placed in an open sky holder filled with physiological liquid (BSS) covered by a glass plate. A numerical camera was associated with metrological software in order to magnify and quantify the results. Transmission electron microscopy (TEM) was performed on some samples to identify the microscopic plasma interactions with the lens. The optimization of parameters was investigated in terms of the optical breakdown threshold, the sizing of interactions, and the best pattern for alignments. More than 150 crystalline lenses of freshly enucleated pigs were treated. The optical breakdown threshold (OBT) was defined as the minimal energy level per pulse necessary to observe a physical interaction. In our study, the OBT varied according to the following parameters: the crystalline lens itself, varying from 4.2 to 7.6 μJ (mean, 5.1 μJ), and the depth of laser focus, varying up to 1 μJ, increasing in the depth of the tissue. Analyzing the distance between impacts, we observed that the closer the impacts were the less power was needed to create a clear well-drawn defect pattern (lines), i.e., with a 4-μJ optimized OBT, when the impacts were placed every 2 μm for the x,y directions and 60 μm for the z direction. Coalescent bubbles created by plasma formation always disappeared in less than 24h. The nonthermal effect of plasma and the innocuousness on surrounding tissues were proven by the TEM results. The crystalline lens photodisruption by the femtosecond laser seems an innovative technique usable in the ultra precise crystalline lens cutting. Experimental studies in vivo are necessary in order to define of them the applications (surgery of the cataract and presbyopia) and limits in the cavitations bubbles kinetic and transfer.