Interface morphology and gas production by a refractive 347 nm ultraviolet femtosecond laser: Comparison with established laser systems.

PURPOSE: To evaluate gas production and interface quality after refractive lenticule creation. A new ultraviolet (UV) 347 nm femtosecond laser was compared with the FS200 and the Visumax lasers.
SETTING: Department of Anatomy II, University of Erlangen-Nürnberg, Erlangen, Germany.
DESIGN: Experimental study.
METHODS: Refractive lenticules were created in 52 porcine corneas with the UV laser (n = 20), the Visumax laser (n = 20), and a modified FS200 laser (n = 12). Twelve corneas in each laser group were fixed immediately after lenticule creation to entrap the gas produced. Lenticule extraction was omitted. From 16 other corneas (UV and Visumax lasers; n = 8 each) -5.0 diopter (D) and -10.0 D lenticules were extracted. On lenticule extraction, a flap was created and lifted. In 12 additional corneas, a flap was cut using the FS200 laser and lifted afterward; laser in situ keratomileusis was performed on 8 of these samples. The corneas were processed for light microscopy (gas bubble 2-dimensional morphometry) and scanning electron microscopy (interface quality).
RESULTS: The Visumax generated approximately one half as much gas as the FS200. The UV laser undercut the Visumax by another 50%. The interfaces created by the FS200 appeared smooth and without irregularities. The optical zone margin was always conspicuous in the Visumax samples but hardly discernible in the UV specimens. Slight irregularities and very small lenticule pieces were found occasionally in both groups. The UV interfaces appeared slightly rougher than the Visumax interfaces.
CONCLUSIONS: Ultraviolet laser lenticule extraction seems promising. The interface quality was similar to that of the clinical Visumax system while gas production was reduced significantly.