High precision subsurface photodisruption in human sclera

Background and objectives: Femtosecond pulses can generate high precision subsurface photodisruption in transparent tissues, such as the cornea. We used femtosecond laser technology to demonstrate early proof of concept for high precision subsurface photodisruption in the translucent sclera. This technique may ultimately enable novel surgical procedures for the treatment of glaucoma and/or presbyopia. Study design/materials and methods: Microjoule femtosecond pulses from two different sources, 1060 and 775 nm, were used to make subsurface incisions in human sclera in vitro. Scleral tissue was dehydrated to improve translucency at these wavelengths. The beam was focused to a 1.5 (775 nm) or 5 mum spot size (1060 nm) and scanned below the tissue surface at various depths to produce four incision patterns. Results: Photodisruption on the backsurface of the sclera was achieved without damage to overlying tissue. Several types of intrascleral incisions were made, including transcleral channels and grooves for scleral implants. Conclusions: High precision, subsurface scleral photodisruption can be achieved in vitro for a variety of intrascleral incisions. Further studies are required to determine if this technique is applicable in vivo for actual surgical applications. (C) 2002 Society of Photo-Optical Instrumentation Engineers.