Photodisruption of a thin membrane near a solid boundary: an in vitro study of laser capsulotomy

Abstract

A Nd:YAG laser photodisruption is a well-established tool for intraocular surgery, such as treatment of posterior capsule opacification that affects the visual function. During the intraocular procedure, called laser capsulotomy, the excitation pulse is focused several times just behind the posterior capsule and intraocular lens to create the central opening in the opacified capsule. We built an in vitro experiment to (1) clarify the influence of the distance between the intraocular lens and the posterior capsule on the total pulse energy required for the capsulotomy, and (2) investigate the main mechanisms responsible for the posterior capsule opening. In our in vitro model, different distances between the solid boundary (imitating an intraocular lens) and the membrane (imitating the posterior capsule) simulate different types of posterior capsule opacification. Our results show that procedure efficiency decreases by decreasing distance between the lens and the capsule. We also explain that for smaller distances between the pulse focus and the membrane, plasma and shock wave are responsible for the capsule disruption. Here, a risk of collateral damage significantly increases. On contrary, the membrane and the bubble jet disrupt the membrane, when pulse focus is moved away and the risk of intraocular lens damage decreases. However, the membrane disruption is not very effective, if it is placed near the solid boundary that inhibits the membrane jet.