Stress wave amplitudes during laser surgery of the cornea.
OBJECTIVE
To determine the stress wave amplitudes generated during photoablation of the cornea using an argon fluoride excimer laser.


METHODS
Experimental study using porcine eyes.


METHODS
Profiles of the stress wave amplitudes and enucleated human eyes along the axis of symmetry of porcine eyes and enucleated human eyes were measured using a miniature piezoelectric transducer. The ablation parameters, fluence, and ablation diameters were varied within the range of clinical application.


METHODS
Stress wave amplitudes generated during photoablation.


RESULTS
The stress waves pass through a pressure focus located in the posterior lens and anterior vitreous, where amplitudes of up to 100 atm were measured with a 6-mm or larger ablation zone. Posterior to this focus, the stress wave amplitudes rapidly decrease to less than 10 atm at the retinal site. Small diameter excimer laser spots (< or =1.5 mm) produce a declining stress wave with no pressure focus at the lens and anterior vitreous.


CONCLUSIONS
Stress waves may be potentially hazardous to anterior structures of the human eye, including the corneal endothelium, lens and anterior vitreous face. They peak at the lens and vitreous with a broad beam, but not with small spot laser ablation. At posterior retinal and subretinal structures, they may be considered harmless.
Krueger
R R
RR
Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Seiler
T
T
Gruchman
T
T
Mrochen
M
M
Berlin
M S
MS
D000818:Animals; D003315:Cornea / Q000601:surgery*; D003316:Corneal Diseases / Q000209:etiology*; D015353:Eye Enucleation; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D054018:Lasers, Excimer; D018903:Photorefractive Keratectomy / Q000009:adverse effects*; D013312:Stress, Physiological / Q000209:etiology*; D013552:Swine; D014732:Vibration