Background: With the assistance of ultrashort laser pulses (ca. 200 fs pulse duration) it is possible to perform precise incisions inside the corneal stroma with a width of a few microns. The advantage of ultrashort pulses is that the required energy of a few microjoules is more than an order of magnitude lower compared with longer pulse durations, i.e. ps or ns pulses. Therefore, the secondary effects, such as thermal and mechanical damage to the surrounding tissue and the amount of radiation reaching the retina, are reduced. This method of intrastromal photodisruption allows a very well defined deposition of energy within the laser focus inside the corneal stroma, accompanied by minimal collateral damage.
Methods: The possibilities of performing intrastromal cuts using fs-laser pulses at a wavelength of 780 nm and pulse durations of 200 fs were studied using a titanium-sapphire laser system. The treated tissue samples were analysed by light and scanning electron microscopy to determine incision quality, reproducibility and achievable accuracy. The mechanical side effects of fs-photodisruption inside the surrounding tissue were analysed by pressure measurements using pyroelectric transducers.
Conclusion: The thermal and mechanical side-effects of this method are very low and comparable to the effects during excimer treatment. Therefore an application of ultrashort laser pulses in refractive surgery appears to be a feasible alternative.