Corneal damage threshold induced by supercontinuum source: A further study

Lasers Surg Med. 2023 Nov;55(9):846-852. doi: 10.1002/lsm.23722. Epub 2023 Sep 1.

Abstract

Objectives: Previous report shows that corneal spot size is an important influence factor on damage threshold induced by supercontinumm (SC) source. However, damage thresholds were determined for the spot size of only 0.37 mm due to the low output of the employed SC source at that time. The objectives of this study are to determine the lowest possible corneal damage threshold at a large corneal spot size using a more powerful SC source and provide data for the future possible refinements of laser safety standards.

Materials and methods: A series of experiments was conducted in the New Zealand white rabbit model to determine the corneal damage threshold induced by a 900-2000 nm SC source, with corneal 1/e beam diameter of about 1.2 mm. Slit-lamp biomicroscope was employed to reveal the corneal damage characteristics. By employing the action spectra determined through the analysis of current laser safety guidelines and standards, the effective damage threshold could be calculated.

Results: The determined damage threshold given in terms of the peak radiant exposure for the exposure duration of 0.14 s was 44.3 J/cm2 . At threshold level, corneal damages involved the epithelium and the shallower stroma. The safety factor between the effective damage threshold and the corresponding maximum permissible exposure (MPE) was about 45.

Conclusions: Present corneal MPEs in the wavelength range of 700-1200 nm may be conservative and corneal damage thresholds for the infrared A wavelengths should be determined in future studies.

Keywords: corneal damage; safety standard; supercontinuum; threshold.