Influence of optical aberrations on laser-induced plasma formation in water and their consequences for intraocular photodisruption.

The influence of spherical aberrations on laser-induced plasma formation in water by 6-ns Nd:YAG laser pulses was investigated for focusing angles that are used in intraocular microsurgery. Waveform distortions of 5.5lambda and 18.5lambda between the optical axis and the 1/e(2) irradiance values of the laser beam were introduced by replacement of laser achromats in the delivery system by planoconvex lenses. Aberrations of 18.5lambda increased the energy threshold for plasma formation by a factor of 8.5 compared with the optimized system. The actual irradiance threshold for optical breakdown was determined from the threshold energy in the optimized system and the spot size measured with a knife-edge technique. For aberrations of 18.5lambda the irradiance threshold was 48 times larger than the actual threshold when it was calculated by use of the diffraction-limited spot size but was 35 times smaller when it was calculated by use of the measured spot size. The latter discrepancy is probably due to hot spots in the focal region of the aberrated laser beam. Hence the determination of the optical-breakdown threshold in the presence of aberrations leads to highly erroneous results. In the presence of aberrations the plasmas are as much as 3 times longer and the transmitted energy is 17-20 times higher than without aberrations. Aberrations can thus strongly compromise the precision and the safety of intraocular microsurgery. They can further account for a major part of the differences in the breakdown-threshold and the plasma-transmission values reported in previous investigations.