In vitro study of cataract extraction by bursts of microsecond 1.54-μm laser pulses

Laser extraction of a model porcine eye cataract has been performed for the first time in an in vitro experiment using a 1.54-μm Yb,Er : glass laser generating bursts of microsecond pulses. We used effective pulse repetition rates from 36 to 75 Hz and average laser output powers from 3.9 to 5.25 W. The results demonstrate for the first time that, at an effective pulse repetition rate of 45 Hz, burst repetition rate of 15 Hz, three microsecond pulses per burst, and a burst energy from 260 to 265 mJ, the laser step duration in cataract extraction is 130 ± 10 s, which is comparable to the ultrasonic phacoemulsification and laser extraction time in the case of a Nd : YAG laser emitting at 1.44 μm. Acoustometry and high speed video recording of hydroacoustic processes accompanying interaction of water with 1.54-μm radiation from the Yb, Er : glass laser generating bursts of microsecond pulses have made it possible for the first time to detect overlap of hydroacoustic processes at the pulse spacing in bursts reduced to under 700 μs. In the case of overlap of hydroacoustic processes, despite the increase in average power and effective pulse repetition rate, acoustic wave generation is ineffective because pulses propagate through bubbles formed in the water. Laser cataract extraction is shown to be most effective at a lower average power, lower effective pulse repetition rate, and burst pulse spacing of 850 ± 10 μs.