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A key step in the design of an accommodating gel to replace the natural contents of the presbyopic human crystalline lens is to find the equivalent homogeneous mechanical and material properties of the gel that yield comparable optical response as the lens with gradient properties. This process is compounded by the interplay between the mechanical and optical gradient. In order to find uniform properties of the lens both gradients need to be considered. In this paper, numerical ray-tracing and finite element method (FEM) are implemented to investigate the effects of varying the uniform elasticity and refractive index on the accommodative amplitude. Our results show that the accommodative amplitude be expressed as a function of gel refractive index and Young's modulus of elasticity. In other words infinite sets of elasticity and refractive index exist that yield a certain amount of accommodation.

In this study, we utilize a confocal ultrasound and phase-sensitive optical coherence elastography (OCE) system to assess age-related changes in biomechanical properties of the crystalline lens in intact rabbit eyes in situ. Lowamplitude elastic deformations, induced on the surface of the lens by localized acoustic radiation force, were measured using phase-sensitive OCT. The results demonstrate that the displacements induced in young rabbit lenses are significantly larger than those in the mature lenses. Temporal analyses of the elastic waves are also demonstrated significant difference between young and old lenses, indicating that the stiffness of lens increases with the age. These results demonstrate possibility of OCE for completely noninvasive analysis and quantification of lens biomechanical properties, which could be used in many clinical and basic science applications such as surgeries and studies on lens physiology and function.

Noninvasively probing the biomechanical properties of crystalline lens has been challenging due to its unique features such as location inside the eye and being optically and ultrasonically transparent. Here we introduce a method of relying on the spectral analysis of the lens surface response to a mechanical stimulation for the depthdependent assessment of lens biomechanical properties. In this method, acoustic radiation force (ARF) is used to remotely induce the deformation on the surface of the crystalline lens, and a phase-sensitive optical coherence tomography (PhS-OCT) system, co-focused with ARF, utilized to monitor the localized temporal response of ARFinduced deformations on the lens surface. The dominant frequency from the amplitude spectra of the surface response is obtained as the indicator of the depthwise elasticity distribution. Pilot experiments were performed on tissue-mimicking layered phantoms and ex vivo porcine crystalline lens. Results indicate that the frequency response of the sample surface is contributed by the mechanical properties of layers located at different depths and the depthdependent elastic properties can be revealed from the amplitude spectrum. Further study will be focused on combining the experimental measurements with theoretical model and inverse numerical method for depth-resolved elastography of the crystalline lens.

A custom-built OCT system was used to obtain images of the whole mouse eye. We developed a semi-automated segmentation method to detect the boundaries of the anterior and posterior corneal, lens and retinal surfaces as well as the anterior surface of the iris. The radii of curvature of the surfaces were calculated using a conic section fit of each boundary. Image distortions due to refraction of the OCT beam at the successive boundaries were corrected using a ray-tracing algorithm. Corrected ocular distances, radii of curvature of the cornea and lens surfaces, and anterior chamber angle were obtained on 3 C57BL/6J mice. In vivo imaging of the whole eye, segmentation, conic function fits and correction were successful in all three animals. The posterior lens surface of one mouse could not be fit accurately with a conic section. Biometric parameters of C57BL/6J mice compared well with previous published data obtained from histological sections. The study demonstrates the feasibility of quantitative in vivo biometry of mouse models.

This PDF file contains the front matter associated with SPIE Proceedings Volume 6844, including the Title Page, Copyright information, Table of Contents, Introduction (if any), and the Conference Committee listing.© (2008) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.

Purpose. The purpose of this study was to evaluate if changes in the aberration-contribution of the internal optics of the eye have a significant effect on the outcome of wavefront-guided corneal reshaping. Methods. The Navarro-Escudero eye model was simulated using optical analysis software. The eye was rendered myopic by shifting the plane of the retina. Custom-LASIK was simulated by changing the radius of curvature and asphericity of the anterior corneal surface of the eye model. The radius of curvature was adjusted to provide a retinal conjugate at infinity. Three approaches were used to determine the postoperative corneal asphericity: minimizing third-order spherical aberration, minimizing third-order coma, and maximizing the Strehl ratio. The aberration contribution of the anterior corneal surface and internal optics was calculated before and after each simulated customized correction. Results. For a 5.2mm diameter pupil, the contribution of the anterior corneal surface to third-order spherical aberration and coma (in micrometers) was 2.22 and 2.49 preop, -0.36 and 2.83 postop when spherical aberration is minimized, 5.88 and 1.10 postop when coma is minimized, and -0.63 and 2.91 postop when Strehl ratio is maximized. The contribution of the internal optics of the eye to spherical aberration and coma for the same four conditions was: 0.43 and -1.13, 0.37 and -1.10, 0.37 and -1.10 and 0.37 and -1.10, respectively. Conclusion. In the model eye, the contribution of the internal optics of the eye to the change in the ocular aberration state is negligible.

Purpose: To design a non-contact optical system to measure lens capsule thickness in cadaver eyes. Methods: The optical system uses a 670nm laser beam delivered to a single-mode fiber coupler. The output of the fiber coupler is focused onto the tissue using an aspheric lens (NA=0.68) mounted on a motorized translation stage. Light reflected from the sample is collected by the fiber coupler and sent to a silicon photodiode connected to a power meter. Peaks in the power signal are detected when the focal point of the aspheric lens coincides with the capsule boundaries. The capsule thickness is proportional to the distance between successive peaks. Anterior and posterior lens capsule thickness measurements were performed on 13 human, 10 monkey, and 34 New Zealand white rabbit lenses. The cadaver eyes were prepared for optical measurements by bonding a PMMA ring on the sclera. The posterior pole was sectioned, excess vitreous was removed, and the eye was placed on a Teflon slide. The cornea and iris were then sectioned. After the experiments, the lenses were excised, placed in 10% buffered formalin, and prepared for histology. Results: Central anterior lens capsule thickness was 9.4±2.9μm (human), 11.2±6.6μm (monkey), and 10.3±3.6μm (rabbit) optically and 14.9±1.6μm (human), 17.7±4.9μm (monkey), and 12.6±2.3μm (rabbit) histologically. The values for the central posterior capsule were 9.4±2.9μm (human), 6.6±2.5μm (monkey), and 7.9±2.3μm (rabbit) optically and 4.6±1.4μm (human), 4.5±1.2μm (monkey), and 5.7±1.7μm (rabbit) histologically. Conclusions: This study demonstrates that a non-contact optical system can successfully measure lens capsule thickness in cadaver eyes.

Purpose. Pseudo-accommodating intra-ocular lenses (P-IOL) have been available for some time and the availability of accommodating IOL (A-IOL) is imminent. While these types of devices have been tested empirically, few studies have addressed the fundamental parameters governing their performance limits. We modelled the amplitude of accommodation of A-IOLs and P-IOLs to analyse parameters controlling their performance. Methods. Two types of two-element A-IOLs (those with a mobile anterior optical element, or a mobile posterior element) were modelled. Paraxial models were developed to identify key controlling parameters and potential optimal configurations, followed by finite modelling using computer assisted ray-tracing employing equi-convex/concave optical elements. A range of configurations representing varying focal lengths of front and back optical elements were tested. Degenerate cases representing P-IOLs were also tested. Results. P-IOLs have limited rate of pseudo-accommodation with axial shift (approximately 1.2D/mm). For A-IOLs, configurations with positive power front elements returned best rate of accommodation (up to approximately 3.0D/mm when the front element focal length is 25 mm). Conclusions. Considering the maximum potential amounts of axial shifts available, P-IOLs were predicted to provide less than 1D of accommodation whereas A-IOLs may provide up to 3-4D of accommodation, depending on design configuration.

Purpose: The purpose of this study was to determine the effects of temperature and heating duration on the kinetics of thermal shrinkage in corneal strips using a custom-made shrinkage device. Methods: Thermal shrinkage was induced and measured in corneal strips under a constant load placed while bathed in 25% Dextran irrigation solution. A study was performed on 57 Florida Lions Eye Bank donated human cadaver eyes to determine the effect of temperature on the amount and rate of thermal shrinkage. Further experiments were performed on 20 human cadaver eyes to determine the effects of heating duration on permanent shrinkage. Data analysis was performed to determine the effects of temperature, heating duration, and age on the amount and kinetics of shrinkage. Results: Shrinkage consisted of two phases: a shrinkage phase during heating and a regression phase after heating. Permanent shrinkage increased with temperature and duration. The shrinkage and regression time constants followed Arrhenius type temperature dependence. The shrinkage time constants where calculated to be 67, 84, 121, 560 and 1112 (s) at 80, 75, 70, 65, and 60°C respectively. At 65°C the permanent shrinkage time constant was calculated to be 945s. Conclusion: These results show that shrinkage treatments need to raise the temperature of the tissue above 75°C for several seconds in order to prevent regression of the shrinkage effect immediately after treatment and to induce the maximum amount of permanent irreversible shrinkage.

The potential of ns pulses of 266 nm from a frequency shifted Nd:YAG laser for corneal ablation was tested on human eye bank eyes. Scanning electron microscopy demonstrated that consecutive pulses in the same spot induced thermal damage that was related to the pulse energy. The ablation threshold was estiamted to 4.5 J/cm2. The ablation per pulse slightly above threshold was 0.2-0.6 μm. It is concluded that the precision of the ablation is relevant for refractive ablations of the cornea. The higher radiation exposure required for corneal ablation at 266 nm compared to that for shorter wavelengths induces higher energy load on the cornea. To avoid heat build-up, a random flying spot is probably needed.

Purpose: To develop a technique to assess isotonic solutions for crystalline lens preservation. Methods: BSS, Ringer’s, Dulbecco’s Modified Eagle Medium (DMEM), and TC 199 have been selected for experimentation. Donor human cadaver lenses are extracted by cutting the zonules and vitreous adherences. A custom-made testing cell and modified optical comparator are used for imaging, and the lens diameter and thickness profiles are measured using digital photography and a graphics program. Measurements are taken every 5 minutes for the 1st hour and then every 15 minutes for 4 hrs. The volume of the lens at each interval is approximated, assuming rotational symmetry, by using the equation for the volume of an ellipsoid. The changes in diameter, thickness, and volume versus time are analyzed to compare the effect of each solution. Results: The measurement resolution for the digital technique is 13μm. Lens thickness changed more significantly than diameter and volume. All four solutions produced similar preliminary results with maximum diameter, thickness, and volume changes of approximately -2%, +6%, and +3%, respectively. Conclusion: Shadowphotogrammetry can measure the lens physical dimensions to +/-13um and can be used to determine the effect of preservation media. This technique may be useful for assessing the physical effects of chemical and biological substances on the lens osmotic transport system.

Purpose: To assess the effects of immersion solutions with different Dextran concentrations on the hydration of cornea tissue strips at normal body temperature. Methods: A 20% Dextran-BSS solution was injected via a self sealing limbal-transcorneal tunnel incision using a 30ga needle into the anterior chamber of human donor eyes until the globe was hard. The eyes were then immersed cornea down overnight in the same solution. Corneal thickness was measured by ultrasound pachymetry after the eyes were re-inflated and at regular intervals to assess dehydration. When the central cornea thickness reached 400-500μm corneal buttons were removed using a 10mm trephine. The buttons were then cut into 6×6mm strips using a custom-made jig and immediately immersed in solutions of Dextran (15 to 20% in increments of 2.5%) at 35°C. The edge thickness of the immersed strip was measured every 5 min for one hour using an optical comparator (Topcon, Japan) modified for tissue shadowphotogrammetry. Results: For five Florida Lions Eye Bank donated eyes after one hour in the Dextran solution the mean final measured thickness of corneas in 20%, 17.5% and 15% Dextran-BSS solutions were 570 (±75) μm, 680 (±70) μm, and 1080 (±95) μm respectively. These measured thicknesses changes correspond to an average swelling of 1.2, 1.4 and 2.2 times the initial thickness of each cornea strip in the 20%, 17.5% and 15% Dextran-BSS solutions respectively. Conclusion: This study demonstrates hydration has a significant effect on the thermal stability and shrinkage dynamics of the cornea. A 25% Dextran solution was found to keep corneal tissue strip thickness at normal values.

Purpose: The purpose of this work was to develop a model to predict and compare laser-trabecular meshwork interactions during laser trabeculoplasty with three different lasers. Methods: A qualitative multilayer optical-thermal model of the trabecular meshwork was developed. The model was used to estimate the penetration depth and heat diffusion volume during laser trabeculoplasty with a continuous wave argon laser (ALT), a Q-switched frequency-doubled Nd:YAG laser (SLT), and a flashlamp-pumped near-infrared alexandrite or titanium sapphire laser emitting microsecond pulses (μs-IRLT). Results: The model predicts that both SLT and μs-IRLT produce selective heating of pigmented trabecular meshwork cells with negligible heat diffusion to surrounding structures and with a deeper penetration at the IR wavelength. A preliminary quantitative analysis indicates that selective targeting of spherical pigments is achieved as long as the pulse duration remains less than approximately 1μs. Conclusion: The qualitative model indicates that infrared laser trabeculoplasty with microsecond pulses can produce selective targeting of pigemented trabecular meshwork cells with a deeper penetration than SLT.

The central part of a PMMA or acrylic resin lens was modified into hydrophobic and the peripheral part to be phydrophilic using teh ArF laser and excimer lamp. PMMA or acrylic resin lens have been used as an intraocular lens for 50 years and is the golden standard in ophthalmology. However, protein and fat are stuck onto the IOL surface after long-term implantation and opacify the surface )after-cataract). Therefore, the central part of the IOL was modified to be hydrophobic to prevent fat and protein deposition; the periphery was made hydrophilic to develop affinity for tissue.

The purpose of these preliminary experiments was to calculate the activation energy and the frequency factor constants of the Arrhenius equation for prediction of the denaturation zone produced by laser interstitial thermotherapy in female breast tissue models. In a first step, pairs of parameters consisting of the activation energy (ΔE) and frequency factor (A) were calculated for different half denaturation times at 50°C and 60°C. Pairs of parameters were eliminated if the calculated time of denaturation at 70°C was excessively short (

The aim of this project is the development of a microsurgical laser Doppler (LD) probe that simultaneously monitors blood flow and Electrocochleography (ECochG) from the round window of the ear. The device will prevent neurosensory hearing loss during acoustic neuroma surgery by preventing damage to the internal auditory nerve and to the cochlear blood flow supply. A commercially available 0.5 mm diameter Laser-Doppler velocimetry probe (LaserFlo, Vasamedics) was modified to integrate an ECochG electrode. A tube for suction and irrigation was incorporated into a sheath of the probe shaft, to facilitate cleaning of the round window (RW) and allow drug delivery to the round window membrane. The prototype microprobe was calibrated on a single vessel model and tested in vivo in a rabbit model. Preliminary results indicate that the microprobe was able to measure changes in cochlear blood flow (CBF) and ECochG potentials from the round window of rabbits in vivo. The microprobe is suitable for monitoring cochlear blood flow and auditory cochlear potentials during human surgery.

Purpose: the purpose of these experiments was to evaluate the temperature and predicted cell kill distribution during LITT of breast tissue phantoms at 940nm and compare with the results of previous experiments ar 830 nm and 980 nm. Material and Methods: A Dornier Medilas D Skinpulse 940 nm diode lase system coupled to a Dornier D-6111-T2 fiber (Dornier Surgical Products, Phoenix, AZ) was used to irradiate the porcine tissue three times at approximately 5 W for 10 minutes. Results: The initial rate of temperature increase at 940 nm for locations 5, 10, and 15 mm from the fiber axis ranged from 0.076 to 0.142 °C/s, 0.027 to 0.041 °C/s, and 0.008 to 0.013 °C/s, respectively, wile the maximum temperature increase ranged from 37.8 to 46.9 °C, 19.3 to 26.1 °C, 8.6 to 13.0 °C, respectively, temperature curves hed lower slopes at 940 nm than at 830 nm and 980 nm. the maximum temperature increase was higher at 940 nm than at 830 nm. Predicted area of 100% cell kill was approximately 2 cm by 2 cm Conclusion: Results of experiments at 940 nm were more comparable to those at 980 nm than at 830 nm.

The purpose of this study was to design and calibrate a device to measure the dynamics of thermal shrinkage in corneal and scleral strips. The apparatus consists of a thermoelectric cell controlled by a temperature controller designed to generate temperatures up to 90 degree(s)C in rectangular corneal strips; a copper cuvette filled with Dextran solution that holds the corneal strip and a displacement sensor that measures the change in length of the tissue during heat-induced shrinkage. The device was tested on corneal tissue from Florida Eye-Bank eyes that were cut into 2x4mm rectangular strips. Preliminary results indicate that our system can reproducibly create and accurately measure thermally induced corneal shrinkage. Shrinkage experiments will be used to optimize laser parameters for corneal shrinkage during laser thermokeratoplasty and laser scleral buckling.

To (1) quantify changes in corneal topography induced by radial anterior sclerostomy for restoring accommodation and, (2) assess safety and ant fibrosis activity of cross-linked sodium hyaluronic acid (cSHA) based gels in ACS procedures. Methods (ex-vivo study): 6 fresh human Eye-Bank eyes were used. A 15% Dextran solution was injected in the anterior chamber and the vitreous cavity, the corneal epithelium was removed by scraping, and the whole eye was immersed in 15% Dextran solution until corneal thickness reached a physiological value. The conjunctiva and tenon capsule were removed and the eye was mounted on a custom-made holder. Preoperative corneal topography was measured with a PAR corneal topography system. Five to eight 3mm-long linear equidistant anterior radial incisions starting from the limbus were performed in the sclera at 90% depth with a diamond blade. Postoperative corneal topography was measured. The files providing the pre and postoperative tangential curvature along meridians separated by 5 degrees were exported. The axial curvature along the 0 and 90-degree meridians before and after surgery were compared. Methods (in-vivo study): Of 24 rabbits, 4 were operated following Thornton's (90% depth incision) and 20 following Fukasaku's (100% depth) techniques (total peritomy, four 4mm long radial scleral incisions starting 0.5 mm from the limbus).© (2002) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.

Purpose. Experimentally find a method to provide a safe surgical technique and an inexpensive and long lasting mesoplant for the restoration of vision in patients with bilateral corneal blindness due to ocular surface and stromal diseases. Methods. Identify the least invasive and the safest surgical technique for synthetic cornea implantation. Identify the most compatible biomaterials and the optimal shape a synthetic cornea must have to last a long time when implanted in vivo. Results. Penetrating procedures were deemed too invasive, time consuming, difficult and prone to long term complications. Therefore a non-penetrating delamination technique with central trephination was developed to preserve the integrity of Descemet's membrane and the anterior segment. Even though this approach limits the number of indications, it is acceptable since the majority of patients only have opacities in the stroma. The prosthesis was designed to fit in the removed tissue plane with its skirt fitted under the delaminated stroma. To improve retention, the trephination wall was made conical with the smallest opening on the anterior surface and a hat-shaped mesoplant was made to fit. The skirt was perforated in its perimeter to allow passage of nutrients and tissues ingrowths. To simplify the fabrication procedure, the haptic and optic were made of the same polymer. The intrastromal biocompatibility of several hydrogels was found superior to current clinically used PMMA and PTFE materials. Monobloc mesoplants made of 4 different materials were implanted in rabbits and followed weekly until extrusion occurred. Some remained optically clear allowing for fundus photography. Conclusions. Hydrogel synthetic corneas can be made to survive for periods longer than 1 year. ArF excimer laser photoablation studies are needed to determine the refractive correction potential of these mesoplants. A pilot FDA clinical trial is needed to assess the mesoplant efficacy and very long-term stability.© (2002) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.

Purpose. The purpose of this study was to develop a model to predict the corneal temperature and shrinkage during laser thermokeratoplasty and other clinical procedures relying on laser-induced thermal shrinkage of collagenous tissue. Methods. The corneal temperature was calculated by solving the bio-heat equation during laser irradiation using a semi-analytical technique. To calculate shrinkage, we assumed that corneal thermal shrinkage is a thermal denaturation process that follows an Arrhenius equation, and that shrinkage resulting from denaturation is proportional to the amount of thermal damage. We calculated shrinkage for pulsed Ho:YAG laser thermokeratoplasty using the clinical treatment algorithm. Results. The thermal model predicts that the corneal temperature reaches values that may be high enough to induce surface vaporization of the epithelium and thermal damage of the endothelium. Shrinkage calculations show that significant shrinkage is produced only after the third laser pulse. Shrinkage is produced mainly during laser pulses and stops shortly after the start of the cooling phase between laser pulses. Conclusions. These calculations demonstrate that thermal shrinkage can be predicted by combining an optical-thermal model and a thermal denaturation model. Accurate quantitative prediction of the shrinkage effect requires a better knowledge of the dynamics of shrinkage and of the optical thermal response of the cornea.

The purpose of these experiments was to compare the temperature increase in ex-vivo porcine mammary chain tissue as a breast tissue model during interstitial laser irradiation with diode lasers emitting at 980 nm and 830 nm. Both wavelengths were delivered at 4.0 W for 10 minutes through a diffusing fiber inserted into ex-vivo porcine tissue. The temperature was measured with a set of 15 thermocouples placed 5, 10, and 15 mm from the fiber axis. The initial rate of temperature increase 5 mm away from the fiber tip was higher at 980 nm (0.12 to 0.20 degree(s)C/s) than at 830 nm (0.10 to 0.16 degree(s)C/s). At 10 mm and 15 mm (areas with less radiation), the rate was smaller than at 5 mm (less than 0.06 degree(s)C/s at 10 mm and less than 0.02 degree(s)C/s at 15 mm) for both wavelengths with no significant difference between the 980 nm and 830 nm radiation. The temperature increase at 5, 10 and 15 mm away from the fiber tip after 10 minutes of irradiation was higher at 980 nm (36 to 45 degree(s)C at 5 mm, 14 to 30 degree(s)C at 10 mm and 9 to 17 degree(s)C at 15 mm) than at 830 nm (27 to 33 degree(s)C at 5 mm, 11 to 17 degree(s)C at 10 mm and 8 to 9 degree(s)C at 15 mm) after 10 minutes. These results were found to be highly dependent on tissue composition (muscle vs. fatty tissue).

A tissue phantom for experimental studies in Laser Interstitial ThermoTherapy (LITT) for the treatment of small breast tumors was developed and evaluated. The tissue phantom consists of a polyacrylamide/acrylate hydrogel matrix containing various concentrations of an absorber (Nigrosin) and a scatterer (Intralipid 10% solution), allowing the optical properties to be varied in accordance to experimental need. Temperature measurements in the phantom were performed with a thermocouple array placed symmetrically around the fiber axis during laser irradiation for different output powers, treatment duration, and different concentrations of absorber. A 980 nm diode laser system was used in conjunction with an REM LightStic 360 diffusing tip fiber. The polyacrylamide/acrylate matrix tissue phantom remained stable during laser irradiation and produced reproducible results. The behavior of the temperature curves produced by the phantom during laser irradiation was similar to the behavior of the temperature curves in ex-vivo tissue. Therefore, this tissue phantom can be used as a model for the thermal response of tissue during laser interstitial thermotherapy. The phantom will be used as an experimental model to determine a set of optimum laser treatment parameters for laser interstitial thermotherapy of breast cancer.

Purpose: In scanning photorefractive keratectomy, the corneal surface is reshaped by laser ablation with a scanning beam for the correction of myopia or astigmatism. A precise knowledge of the volume of corneal tissue removed by each laser pulse is necessary to be able to develop accurate ablation algorithms for scanning photorefractive keratectomy. The purpose of this study was to measure the ablation per pulse created on PMMA surfaces with a Q-switched frequency-quintupled Nd:YAG laser emitting at 213 nm. Methods: A frequency-quintupled Nd:YAG laser emitting at 213 nm with a pulse duration of 5 ns and a pulse energy of 1.2 to 1.5 mJ was used. The laser beam was focused on the surface of PMMA blocks and ablation craters were produced with 10, 50 and 100 pulses. The shape of the ablation craters was measured with an optical profilometer and compared with the beam profile measured with a laser beam diagnostic system. Results: The beam intensity distribution in the near-field consisted of two quasi-Gaussian peaks. The ablation craters contained two peaks. Assuming a Gaussian intensity distribution, the ablation per pulse in PMMA at 213 nm can be modeled by a parabolic function. Conclusions: Optical profilometry can be used to accurately measure the ablation per pulse and evaluate the homogeneity of the beam.

glasses have been proposed 17-1 11. In all such designs, it can be seen that rays are passing throughthe cornea at large angles of incidence. Therefore, not only should spherical aberration be consideredbut also astigmatism of oblique incidence. In close similitude with astigmatism of toric surfaces, aStUrm's conold is produced in this case, with two focal lines perpendicular to each other and a circle

Purpose: The goal of the study is to measure the group refractive index of the human cornea in vitro to improve the accuracy of corneal thickness measurements. Methods: Corneal buttons were trephined from 23 human cadaver eyes and the group refractive index of the cornea was measured at lambda equals 840 nm using a low-coherence Michelson interferometer and the technique proposed by Sorin and Gray (Phot. Tech. Lett. 4:105 - 107, 1992). The effect of dehydration on the measurement was studied by measuring the corneal optical thickness as a function of time. Results: Preliminary measurements of the group refractive index at 840 nm gave n g equals 1.450 plus or minus 0.024 for the human cornea, which is much higher than a calculated group refractive index of n g equals 1.387. Because of dehydration, the optical thickness of the cornea decreased at a rate of 5.5 micrometer/minute which led to an artificially high value for the group refractive index. Conclusion: The calculated group refractive index of n g equals 1.387 appears to be an accurate value for the purpose of corneal thickness measurements using low-coherence interferometry, and corneal group refractive index measurements can be performed in vitro if the measurements are performed rapidly to avoid the effect of dehydration.

Purpose: The purpose of this study was to compare with computer simulations the duration, smoothness and accuracy of scanning photo-refractive keratectomy with spot diameters ranging from 0.2 to 1 mm. Methods: We calculated the number of pulses per diopter of flattening for spot sizes varying from 0.2 to 1 mm. We also computed the corneal shape after the correction of 4 diopters of myopia and 4 diopters of astigmatism with a 6 mm ablation zone and a spot size of 0.4 mm with 600 mJ/cm 2 peak radiant exposure and 0.8 mm with 300 mJ/cm 2 peak radiant exposure. The accuracy and smoothness of the ablations were compared. Results: The repetition rate required to produce corrections of myopia with a 6 mm ablation zone in a duration of 5 s per diopter is on the order of 1 kHz for spot sizes smaller than 0.5 mm, and of 100 Hz for spot sizes larger than 0.5 mm. The accuracy and smoothness after the correction of myopia and astigmatism with small and large spot sizes were not significantly different. Conclusions: This study seems to indicate that there is no theoretical advantage for using either smaller spots with higher radiant exposures or larger spots with lower radiant exposures. However, at fixed radiant exposure, treatments with smaller spots require a larger duration of surgery but provide a better accuracy for the correction of astigmatism.

The purpose is to calculate and compare the point-spread function and the central ablation depth (CAD) of a paraxial eye model after photo-refractive keratectomy (PRK), with single and multizone treatments. A modified Le Grand-El Hage paraxial eye model, with a pupil diameter ranging from 2 to 8 mm was used. Ray-tracing was performed for initial myopia ranging from 1 to 10D; after single zone PRK; after double zone PRK; and after tripe zone PRK. The ray-tracing of a parallel incident beam was calculated by using the paraxial matrix method. At equal CAD, the optical image quality is better after single zone treatments. Multizone treatments do not seem to be advantageous optically.

The treatment of primary breast cancer in the last half century has progressively decreased in its disfiguring consequences while maintaining the same level of cure. Extending this philosophy beyond lumpectomy, we propose to treat small primary breast cancers by laser interstitial therapy with minimal possible cosmetic distortion. Our program to achieve that goal has made considerable progress in the preclinical instrument modification and development of physical, tissue, and live animal models. In anticipation of a clinical trial this report updates information presented in 1996.

Endoscopy is a method of observation that allows direct viewing of certain internal structures of the eye which cannot be easily visualized through conventional slit lamp/microscope arrangements. An endoscopic system can also be helpful when a transparent structure of the eye becomes turbid, e.g., a hazy cornea. Over the past years substantial efforts have been oriented to miniaturize endoscopes for use in ophthalmology. Ophthalmic endoscopes have been presented on the basis either of coherently ordered fiber bundles or of optical lenses such as the gradient-index ones (GRIN). Endoscopes that provide a basic visualization function can also be fitted with one or more ancillary channels that may provide additional features such as aspiration/injection or laser treatment.

The smoothness and accuracy of PMMA ablations with a prototype scanning photorefractive keratectomy (SPRK) system were evaluated by optical profilometry. A prototype frequency- quintupled Nd:YAG laser (Laser Harmonic, LaserSight, Orlando, FL) was used (wavelength: 213 nm, pulse duration: 15 ns, repetition rate: 10 Hz). The laser energy was delivered through two computer-controlled galvanometer scanners that were controlled with our own hardware and software. The system was programmed to create on a block of PMMA the ablations corresponding to the correction of 6 diopters of myopia with 60%, 70%, and 80% spot overlap. The energy was 1.25 mJ. After ablation, the topography of the samples was measured with an optical profilometer (UBM Messtechnik, Ettlingen, Germany). The ablation depth was 10 to 15 micrometer larger than expected. The surfaces created with 50% to 70% overlap exhibited large saw-tooth like variations, with a maximum peak to peak variation of approximately 20 micrometer. With 80% overlap, the rms roughness was 1.3 micrometer and the central flattening was 7 diopters. This study shows that scanning PRK can produce smooth and accurate ablations.

Laser scleral buckling (LSB) experiments were performed by irradiating human cadaver eyes with a focused beam from a 2.1-micrometer Ho:YAG laser. Spatially and temporally resolved temperature maps of the sclera were inferred from infrared images of the tissue's thermal radiation. An infrared focal-plane camera operating in the 3- to 5-micrometer wavelength interval was used for the measurements, from which we derived absorption and thermal diffusivity coefficients of the scleral tissue, along with the temperature dependence of these coefficients. A thermal-response model was developed, which describes the tissue surface temperature in response to a train of laser pulses, given the pulse repetition rate, beam fluence, spot size, and total energy delivered. This model provides guidance for optimization of laser-irradiation parameters for LSB treatment.

A mammographic stereotactic core biopsy instrument can be adapted for laser hyperthermic ablation of breast cancer. The object of this study is to characterize laser endohyperthermia ex-vivo and in-vivo to develop a reliable approach leading to human trials. Light of a Nd:YAG laser passed through a fiberoptic cable to a diffusing quartz tip upon entering surrounding tissues can bring about very high temperatures. This approach concentrating on the heat distribution to fat and fibrofatty tissue, first analyzed a physical model into which both the quartz tip and thermocouple needles were placed. Temperature recordings in volume through a time course demonstrated a progressive thermal increase around the tip. Additional light distribution studies in several media demonstrated the tip's output. The technique transferred to ex-vivo human breast and porcine fibrofatty tissue showed similar findings leading to an in-vivo analysis of subcutaneous porcine fibrofatty tissue. A step-down energy program beginning at 20 watts and decreasing to 15 watts, 10 watts, and to 7 watts, at 30 second intervals was held at the latter power for the remainder of 6 minutes. Three such cycles appear to be the optimal treatment program to develop temperatures between 60 degrees Celsius and 80 degrees Celsius (approximately equals 9700 joules). In-vivo experiments conducted on 5 occasions revealed no skin change. At necropsy the treated tissues demonstrated a circular sharply defined 3 cm volume of necrosis with no change in adjacent tissue. Time-temperature correlations between ex-vivo and in-vivo tissues showed great similarity. Nd:YAG laser energy distributed to a quartz tip through a fiberoptic cable is capable of uniform, complete tissue destruction to a 1 1/2 cm radius with no change beyond that field. This technique with further refinement will be appropriate to the treatment of small breast cancers that have been stereotactically biopsied.© (1996) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.

Choroidal melanoma is the most common primary malignant ocular tumor, yet none of the several available treatments is wholly successful. One therapy recently tried in humans was transpupillary thermotherapy. In this procedure, an 810 nm wavelength laser beam passes through the cornea, aqueous, lens, and vitreous to be absorbed by the tumor in the back of the eye. The results of transpupillary thermotherapy were encouraging, but in some patients only the anterior portion of the tumor was necrosed while the center and posterior portions remained viable. The new treatment modality proposed in this study is similar in concept to transpupillary thermotherapy, but we propose to apply the laser energy through the sclera onto the posterior portion of the tumor, known as the tumor bed. At infrared wavelengths, sclera has excellent transmission characteristics, while most ocular tumors are mildly absorbing. Some of the laser energy is absorbed in the posterior portion of the tumor, but some transmission of the energy through the tumor allows the anterior portion of the tumor to be heated as well. In qualitative terms, this scheme sounds appealing, but it is not yet known whether it will fulfill the quantitative requirements required to achieve the appropriate biological response -- that is, raising the temperature of the tumor to the level which causes cell necrosis (greater than or equal to 43 degrees Celsius) for the appropriate amount of time, without causing photocoagulation of the tumor (approximately equal to 60 degrees Celsius) or damage to the sclera (approximately equal to 55 degrees Celsius). The calculation of temperature distribution is a complicated matter, however, because the actual result of a rise in temperature happens only after the applied laser light has undergone several physical processes.