Experimental femtosecond laser photodisruption of rabbit sclera for minimally invasive laser sclerostomy: An in vitro study

Femtosecond laser technology, used as a minimally invasive tool in intrastromal refractive surgery, may also have potential as a useful instrument for glaucoma filtration surgery. The purpose of the present study was to evaluate the feasibility of minimally invasive laser sclerostomy by femtosecond laser photodisruption and seek the appropriate patterns of laser ablation and relevant laser parameters. A femtosecond laser (800 nm/50 fs/1 kHz), focused by a 0.1 numerical aperture (NA) objective lens, with different pulse energies and exposure times was applied to ablate hydrated rabbit sclera in vitro. The irradiated samples were examined by scanning electron microscopy (SEM). By moving a three-dimensional, computer-controlled translation stage to which the sample was attached, the femtosecond laser could produce three types of ablation patterns, including linear ablation, cylindrical aperture and rectangular cavity. With pulse energies ranging from 37.5 to 150 μJ, the linear lesions were consistently observed at the inner surface of sclera, whereas it failed to make any photodisruption if pulse energy was below the threshold value of 31.25 μJ, with the corresponding threshold intensity of 4.06×10¹⁴ W/cm². The depths of the linear lesions increased linearly with both pulse energy (37.5–150 μJ) and exposure time (0.1–0.4 s). Histological examination showed the incisions produced by femtosecond laser photodisruption had precise geometry and the edges were sharp and smooth, with no evidence of collateral damage to the surrounding tissue. Our results predict the potential application of femtosecond laser pulses in minimally invasive laser sclerostomy for glaucoma treatment.