利用相关 X 射线和电子显微镜的新型三维高分辨率成像方法研究 Nd:YAG 激光诱导的眼内透镜缺陷。

IF 2 4区 医学 Q2 OPHTHALMOLOGY Ophthalmic Research Pub Date : 2024-01-01 Epub Date: 2024-05-08 DOI:10.1159/000539243
Andreas F Borkenstein, Adrian Mikitisin, Alexander Schwedt, Eva-Maria Borkenstein, Joachim Mayer
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引用次数: 0

摘要

简介白内障摘除术是全球最常见的眼科手术。后囊混浊(PCO)仍是白内障手术后最常见的后遗症,可导致视力恶化,出现视力混浊、模糊、光晕和眩光效应。掺钕钇钕石榴石(Nd:YAG)激光晶体囊切开术是治疗白内障的金标准,也是去除混浊后囊的一种非常有效、安全和快速的手术。在治疗过程中,由于激光束聚焦错误,可能会损伤眼内晶状体。这些 YAG 凹坑可能会导致视觉质量的永久性损害:在一项实验研究中,我们使用 2.6mJ 的光破坏激光有意在亲水性和疏水性丙烯酸眼内透镜(IOLs)上诱发 YAG 凹陷。这项实验研究建立了一种新颖的三维成像方法,使用相关的 X 射线和扫描电子显微镜来描述这些损伤。通过整合从 X 射线显微镜和扫描电子显微镜获得的信息,可以全面了解材料的结构和性能:结果表明,虽然所有样品都使用了完全相同的能量,但在测试镜片中观察到的缺陷在形状和深度上都存在严重差异。亲水性样品中的 YAG 凹坑深度在 100 到 180 微米之间,尖端呈圆形,而疏水性样品中的缺陷尖端非常尖锐,深度可达 250 微米。在所有样品中,表面都发现了人工晶体材料的颗粒/碎片,这些颗粒/碎片是激光去壳的结果:结论:亲水性和疏水性丙烯酸材料的缺陷各不相同。结论:亲水性丙烯酸材料和疏水性丙烯酸材料的缺陷是不同的,材料颗粒会从人工晶体上脱落,并在样品表面被发现。实验室研究结果表明,为了避免对人工晶体造成永久性损伤,必须采用精确、谨慎的方法进行 Nd:YAG 包膜切开术。为提高安全性,应常规使用适当的接触玻璃和后偏置设置。
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A Novel 3D High Resolution Imaging Method Using Correlative X-Ray and Electron Microscopy to Study Neodymium-Doped Yttrium Aluminum Garnet Laser-Induced Defects in Intraocular Lenses.

Introduction: Cataract extraction is the most frequently performed ophthalmological procedure worldwide. Posterior capsule opacification remains the most common consequence after cataract surgery and can lead to deterioration of the visual performance with cloudy, blurred vision and halo, glare effects. Neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy is the gold standard treatment and a very effective, safe and fast procedure in removing the cloudy posterior capsule. Damaging the intraocular lens (IOL) during the treatment may occur due to wrong focus of the laser beam. These YAG-pits may lead to a permanent impairment of the visual quality.

Methods: In an experimental study, we intentionally induced YAG pits in hydrophilic and hydrophobic acrylic IOLs using a photodisruption laser with 2.6 mJ. This experimental study established a novel 3D imaging method using correlative X-ray and scanning electron microscopy (SEM) to characterize these damages. By integrating the information obtained from both X-ray microscopy and SEM, a comprehensive picture of the materials structure and performance could be established.

Results: It could be revealed that although the exact same energies were used to all samples, the observed defects in the tested lenses showed severe differences in shape and depth. While YAG pits in hydrophilic samples range from 100 to 180 µm depth with a round shape tip, very sharp tipped defects up to 250 µm in depth were found in hydrophobic samples. In all samples, particles/fragments of the IOL material were found on the surface that were blasted out as a result of the laser shelling.

Conclusion: Defects in hydrophilic and hydrophobic acrylic materials differ. Material particles can detach from the IOL and were found on the surface of the samples. The results of the laboratory study illustrate the importance of a precise and careful approach to Nd:YAG capsulotomy in order to avoid permanent damage to the IOL. The use of an appropriate contact glass and posterior offset setting to increase safety should be carried out routinely.

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来源期刊
Ophthalmic Research
Ophthalmic Research 医学-眼科学
CiteScore
3.80
自引率
4.80%
发文量
75
审稿时长
6-12 weeks
期刊介绍: ''Ophthalmic Research'' features original papers and reviews reporting on translational and clinical studies. Authors from throughout the world cover research topics on every field in connection with physical, physiologic, pharmacological, biochemical and molecular biological aspects of ophthalmology. This journal also aims to provide a record of international clinical research for both researchers and clinicians in ophthalmology. Finally, the transfer of information from fundamental research to clinical research and clinical practice is particularly welcome.
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