数值孔径对飞秒激光角膜切削的影响  

Effect of Numerical Aperture on Femtosecond Laser Corneal Ablation

作　　者：吕海军 王雨 李华明 张卓宇 赵新恒 吕晓华 刘秀丽 曾绍群 LüHaijun;Wang Yu;Li Huaming;Zhang Zhuoyu;Zhao Xinheng;Lu Xiaohua;Liu Xiuli;Zeng Shaoqun(Britton Chance Center for Biomedical Photonics,MOE Key Laboratory for Biomedical Photonics,Advanced Biomedical Imaging Facility,Wuhan National Laboratory for Optoelectronics,Huazhong University of Science and Technology,Wuhan 430074,Hubei,China;Tianjin Eye Hospital,Affiliated Eye Hospital of Nankai University,Clinical School of Ophthalmology,Tianjin Medical University,Institute of Ophthalmology,Nankai University,Tianjin 300020,China)

机构地区：[1]华中科技大学武汉光电国家研究中心,高端生物医学成像重大科技基础设施,生物医学光子学教育部重点实验室,BrittonChance生物医学光子学研究中心,湖北武汉430074 [2]天津市眼科医院,南开大学附属眼科医院,天津医科大学眼科临床学院,南开大学眼科学研究院,天津300020

出　　处：《中国激光》2024年第9期247-253,共7页Chinese Journal of Lasers

基　　金：国家重点研发计划(2022YFC2404500);国家自然科学基金(62275094);湖北省重点研发计划(2022BCA049)。

摘　　要：飞秒激光得益于其精准、微创等优势被广泛应用于屈光疾病的治疗。在飞秒激光屈光手术中,光学系统的数值孔径是影响手术效果的重要参数。本研究旨在探讨数值孔径对飞秒激光角膜基质切削质量的影响规律,以帮助临床医生更好地选择合适的手术参数。选用0.16、0.30、0.80三种数值孔径进行离体动物角膜的飞秒激光切削实验,并通过气泡尺寸与凋亡细胞比例评估激光切削质量与基质细胞损伤程度。实验结果显示:气泡体积随着数值孔径的增大而减小,高数值孔径下切割更易实现基质层的分离;上述三种数值孔径下的基质细胞损伤比例分别为9.4%、4.9%和1.0%,基质细胞的损伤比例随着数值孔径的增大而明显下降。因此,增大数值孔径有助于提高飞秒激光角膜基质切削的安全性。Objective Corneal laser refractive surgery is a method for correcting vision using lasers to reshape the cornea and change its curvature and thickness.Femtosecond laser corneal cutting is widely used in ophthalmic refractive surgery as a precise,minimally invasive,and controllable surgical technique.In femtosecond laser refractive surgery,the numerical aperture of the optical system determines the focal spot size and required single-pulse energy,which are critical parameters that influence the corneal cutting quality.In this study,we built a femtosecond laser surgery system with an adjustable numerical aperture.We investigated the effect of numerical aperture on cutting quality in the corneal stroma by analyzing the differences in bubble morphology,smoothness of flap separation,and proportion of damaged stromal cells.This study aimed to assist clinicians in selecting the appropriate surgical parameters more effectively.Methods Freshly enucleated pig eyeballs and New Zealand white rabbits were selected as experimental subjects.By adjusting the diameter of the incident beam,corneal flaps were formed on the pig eyeballs using a femtosecond laser with numerical aperture values of 0.16,0.30,and 0.80.The morphology of the bubbles after cutting was recorded,and the smoothness of the separation was observed when the corneal flaps were lifted.Cell damage experiments were conducted by cutting New Zealand white rabbit eyeballs with a femtosecond laser at numerical aperture values of 0.16,0.30,and 0.80.After creating the flap with the femtosecond laser,the rabbit eyeballs were placed in corneal active medium(DX solution)and incubated at 4℃for 6 h to induce apoptosis in the damaged corneal stromal cells.Subsequently,the rabbit eyeballs were removed and prefixed in a 4%paraformaldehyde(PFA)solution for 2 h.After dewaxing and rehydration,the corneal sections were double-stained with DAPI(4,6-diamidino-2-phenylindole,D9542,Sigma-Aldrich)and TUNEL(TdT-mediated dUTP nick end labeling,C1088,Beyotime).Finally,the apoptotic cell co

关 键 词：激光技术 飞秒激光 角膜 数值孔径 气泡 细胞损伤 

分 类 号：R778[医药卫生—眼科]