Intraocular Nd:YAG laser surgery: laser-tissue interaction, damagerange, and reduction of collateral effects

The damage mechanisms of intraocular Nd:YAG laser surgery and their respective damage ranges were investigated in vitro using bovine cornea specimens as a model tissue. The main damage mechanisms are plasma formation and expansion, emission of acoustic transients, and cavitation with jet formation. When a sequence of laser pulses is applied, the interaction of the acoustic transients with gas bubbles remaining from preceding laser exposures is also important. To distinguish the effects caused by the different physical mechanisms, laser pulses were aimed directly onto the corneal endothelium, through the cornea, and parallel to the cornea at various distances. Simultaneously, the cavitation bubble size was determined. The damage range of the acoustic transients produced by a 4 mJ laser pulse is several millimeters, when they can interact with small gas bubbles attached to the corneal endothelium