Journal of cataract and refractive surgery · 2025
Improvement of keratorefractive lenticule creation by application of a vortex beam in a UV femtosecond laser system.
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Hammer Christian M, Zhang Yao, Klafke Mario, Paulsen Friedrich, Lörner Johannes
Аннотация
PURPOSE: To examine the effect of a vortex beam on gas formation and interface quality after keratorefractive lenticule creation with a 347 nm UV femtosecond laser.
SETTING: Anatomy Unit, University of Fribourg, Switzerland; Institute of Functional and Clinical Anatomy, University of Erlangen-Nürnberg, Erlangen, Germany; WaveLight GmbH, Erlangen, Germany.
DESIGN: Experimental study.
METHODS: Refractive corneal lenticules were created in 40 ex vivo porcine eyes with a 347 nm UV femtosecond laser. In 20 eyes, the laser was operated with a (Laguerre-Gaussian) vortex beam (generated by a spiral phase plate), and in the remaining 20 with a normal (Gaussian) beam. In each group, 12 eyes were used for histological quantification of intraoperative gas formation. The remaining 8 eyes were subjected to scanning electron microscopy after lenticule extraction to evaluate the lenticule bed morphology. The vortex group was compared morphologically and morphometrically with the normal group.
RESULTS: Application of a vortex beam significantly decreased the amount of gas produced intraoperatively. Semiquantitative 2D histomorphometrical analysis of the area occupied by gas bubbles yielded 20 156 ± 5591 μm 2 /mm in the normal samples, as compared with 9495 ± 3966 μm 2 /mm in the vortex samples ( P < .001). Moreover, the lenticule beds created by a UV vortex beam were markedly smoother and more regular than those created by a normal UV laser beam.
CONCLUSIONS: Operating a UV femtosecond laser with a vortex beam may significantly decrease the risk of opaque bubble layer formation and increases surgical safety and precision.
SETTING: Anatomy Unit, University of Fribourg, Switzerland; Institute of Functional and Clinical Anatomy, University of Erlangen-Nürnberg, Erlangen, Germany; WaveLight GmbH, Erlangen, Germany.
DESIGN: Experimental study.
METHODS: Refractive corneal lenticules were created in 40 ex vivo porcine eyes with a 347 nm UV femtosecond laser. In 20 eyes, the laser was operated with a (Laguerre-Gaussian) vortex beam (generated by a spiral phase plate), and in the remaining 20 with a normal (Gaussian) beam. In each group, 12 eyes were used for histological quantification of intraoperative gas formation. The remaining 8 eyes were subjected to scanning electron microscopy after lenticule extraction to evaluate the lenticule bed morphology. The vortex group was compared morphologically and morphometrically with the normal group.
RESULTS: Application of a vortex beam significantly decreased the amount of gas produced intraoperatively. Semiquantitative 2D histomorphometrical analysis of the area occupied by gas bubbles yielded 20 156 ± 5591 μm 2 /mm in the normal samples, as compared with 9495 ± 3966 μm 2 /mm in the vortex samples ( P < .001). Moreover, the lenticule beds created by a UV vortex beam were markedly smoother and more regular than those created by a normal UV laser beam.
CONCLUSIONS: Operating a UV femtosecond laser with a vortex beam may significantly decrease the risk of opaque bubble layer formation and increases surgical safety and precision.