Abstract
Purpose :
A novel system with an integrated duo-pulse engine (Gen-2 ALLY, LENSAR, Orlando, FL) offers the flexibility of operating with either a short (femtosecond) or long (picosecond) pulse laser. The purpose of this study is to evaluate the efficacy of each option in corneal treatment and lens fragmentation.
Methods :
Pairs of human donor eyes were utilized. Two full thickness corneal incisions of 2.5mm width each were performed on the eyes 180° apart with each pulse width. Lens fragmentation patterns were generated in each lens using a mask to cover half the lens volume to limit the laser treatment to the exposed half volume for each pulse width. Evaluation of the corneal incisions and lens fragmentation was performed under the surgical microscope.
Results :
Following the short pulse laser treatment, the corneal incisions were consistently easier to open and, in, some cases, gaping. In addition, the intrastromal tunnel was generally free of tissue bridges. With the long pulse laser, the incision was characterized by a residual uncut layer beneath the epithelium that needed to be broken to access the incision. Moreover, the occurrence of an opaque bubble layer (OBL) was more frequent and pronounced with the long pulse laser.
For lens fragmentation, larger surface cleavages were observed in the lens volume treated with the long pulse laser. The size of the cleavage was indicative of the laser’s generation of incisional cuts /cracks that expanded beyond the point of photodisruption, including in opaque/hard cataract volumes. However, with the short pulse laser, the fragmentation cuts exhibited discontinuities in the posterior lens volume in some cases, indicative of its challenge to be consistently effective in cutting the fibrous posterior plate.
Conclusions :
These preliminary data show that a duo-pulse laser offers unique flexibility to use a short pulse laser that is more effective in construction of corneal incisions with the advantages of minimal OBL occurrence, easier opening and absence of tissue-bridges. The long pulse laser is more effective in lens fragmentation with the cuts continued and extended to the posterior lens including the fibrous posterior plate.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.