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Virtual Journal for Biomedical Optics

Virtual Journal for Biomedical Optics

| EXPLORING THE INTERFACE OF LIGHT AND BIOMEDICINE

  • Editor: Gregory W. Faris
  • Vol. 4, Iss. 8 — Jul. 30, 2009
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Interplay of wavelength, fluence and spot-size in free-electron laser ablation of cornea

M. Shane Hutson, Borislav Ivanov, Aroshan Jayasinghe, Gilma Adunas, Yaowu Xiao, Mingsheng Guo, and John Kozub  »View Author Affiliations


Optics Express, Vol. 17, Issue 12, pp. 9840-9850 (2009)
http://dx.doi.org/10.1364/OE.17.009840


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Abstract

Infrared free-electron lasers ablate tissue with high efficiency and low collateral damage when tuned to the 6-µm range. This wavelength-dependence has been hypothesized to arise from a multi-step process following differential absorption by tissue water and proteins. Here, we test this hypothesis at wavelengths for which cornea has matching overall absorption, but drastically different differential absorption. We measure etch depth, collateral damage and plume images and find that the hypothesis is not confirmed. We do find larger etch depths for larger spot sizes – an effect that can lead to an apparent wavelength dependence. Plume imaging at several wavelengths and spot sizes suggests that this effect is due to increased post-pulse ablation at larger spots.

© 2009 OSA

1. Introduction

Infrared free-electron lasers (FELs) can ablate soft biological tissues with high efficiency and remarkably little collateral damage. This is particularly true when an FEL is tuned to the 6-µm wavelength range [1

1. G. Edwards, R. Logan, M. Copeland, L. Reinisch, J. Davidson, B. Johnson, R. Maciunas, M. Mendenhall, R. Ossoff, J. Tribble, J. Werkhaven, and D. O'Day, “Tissue ablation by a free-electron laser tuned to the amide II band,” Nature 371(6496), 416–419 (1994). [CrossRef] [PubMed]

]. For some tissues, the optimal wavelength is 6.1 µm [2

2. J. I. Youn, P. Sweet, G. M. Peavy, and V. Venugopalan, “Mid-IR laser ablation of articular and fibro-cartilage: a wavelength dependence study of thermal injury and crater morphology,” Lasers Surg. Med. 38(3), 218–228 (2006). [CrossRef] [PubMed]

] – corresponding to the overlapping peaks of the amide I vibrational mode of proteins and the bending mode of water. For others, it is 6.45 µm [1

1. G. Edwards, R. Logan, M. Copeland, L. Reinisch, J. Davidson, B. Johnson, R. Maciunas, M. Mendenhall, R. Ossoff, J. Tribble, J. Werkhaven, and D. O'Day, “Tissue ablation by a free-electron laser tuned to the amide II band,” Nature 371(6496), 416–419 (1994). [CrossRef] [PubMed]

,3

3. K. M. Joos, J. H. Shen, D. J. Shetlar, and V. A. Casagrande, “Optic nerve sheath fenestration with a novel wavelength produced by the free electron laser (FEL),” Lasers Surg. Med. 27(3), 191–205 (2000). [CrossRef] [PubMed]

] – corresponding to the tail of the water bending mode and the peak of the amide II vibrational mode of proteins. For others, it is closer to 6.0 µm [4

4. R. A. Hill, Q. Ren, D. C. Nguyen, L. H. Liaw, and M. W. Berns, “Free-electron laser (FEL) ablation of ocular tissues,” Lasers Med. Sci. 13(3), 219–226 (1998). [CrossRef]

]. In all tissues examined, both peaks were superior to wavelengths near 3.0 µm – corresponding to the peak of the water OH stretching mode. This last observation is not without controversy. Other lasers operating near 3.0 µm can also ablate soft tissues efficiently and with little collateral damage [5

5. R. Kaufmann and R. Hibst, “Pulsed erbium:YAG laser ablation in cutaneous surgery,” Lasers Surg. Med. 19(3), 324–330 (1996). [CrossRef] [PubMed]

8

8. J. Kiefer, J. Tillein, Q. Ye, R. Klinke, and W. Gstoettner, “Application of carbon dioxide and erbium:yttrium-aluminum-garnet lasers in inner ear surgery: an experimental study,” Otol. Neurotol. 25(3), 400–409 (2004). [CrossRef] [PubMed]

]. Nonetheless, the Vanderbilt FEL has been used to carry out eight successful human surgeries [9

9. G. S. Edwards, R. H. Austin, F. E. Carroll, M. L. Copeland, M. E. Couprie, W. E. Gabella, R. F. Haglund, B. A. Hooper, M. S. Hutson, E. D. Jansen, K. M. Joos, D. P. Kiehart, I. Lindau, J. Miao, H. S. Pratisto, J. H. Shen, Y. Tokutake, A. F. G. van der Meer, and A. Xie, “Free-electron-laser-based biophysical and biomedical instrumentation,” Rev. Sci. Instrum. 74(7), 3207–3245 (2003). [CrossRef]

,10

10. M. L. Copeland, R. J. Maciunas, and G. S. Edwards, “Chapter VII,” in Neurosurgical Topics: Advanced Techniques in Central Nervous System Metastases, R. J. Maciunas, ed. (The American Association of Neurological Surgeons, Park Ridge, IL, 1998).

]; and tabletop lasers in the 6-µm range are under development to translate this success to more widespread surgical use [11

11. G. S. Edwards, R. D. Pearlstein, M. L. Copeland, M. S. Hutson, K. Latone, A. Spiro, and G. Pasmanik, “6450 nm wavelength tissue ablation using a nanosecond laser based on difference frequency mixing and stimulated Raman scattering,” Opt. Lett. 32(11), 1426–1428 (2007). [CrossRef] [PubMed]

,12

12. M. A. Mackanos, D. Simanovskii, K. M. Joos, H. A. Schwettman, and E. D. Jansen, “Mid infrared optical parametric oscillator (OPO) as a viable alternative to tissue ablation with the free electron laser (FEL),” Lasers Surg. Med. 39(3), 230–236 (2007). [CrossRef] [PubMed]

].

Our current understanding of this wavelength-dependence is based on the fact that the 6-µm range directly targets protein vibrations [13

13. M. S. Hutson, S. A. Hauger, and G. Edwards, “Thermal diffusion and chemical kinetics in laminar biomaterial due to heating by a free-electron laser,” Phys. Rev. E Stat. Nonlin. Soft Matter Phys. 65(6 Pt 1), 061906 (2002). [CrossRef] [PubMed]

15

15. M. S. Hutson, and G. S. Edwards, “Advances in the Physical Understanding of Laser Surgery at 6.45 microns,” in 26th International Free Electron Laser Conference and 11th FEL Users Workshop (Trieste, Italy, 2003) paper: FRAIS01.

]. Researchers have long hypothesized that such direct excitation could lead to a loss of protein structural integrity [1

1. G. Edwards, R. Logan, M. Copeland, L. Reinisch, J. Davidson, B. Johnson, R. Maciunas, M. Mendenhall, R. Ossoff, J. Tribble, J. Werkhaven, and D. O'Day, “Tissue ablation by a free-electron laser tuned to the amide II band,” Nature 371(6496), 416–419 (1994). [CrossRef] [PubMed]

]. This structural failure should then allow tissue removal to occur at lower energy densities and a smaller pressure head, i.e. more efficiently and with less collateral damage. The hypothetical loss of structural integrity has two main difficulties. First, photon energies in the 6-µm range are quite low (~0.2 eV), so a photochemical mechanism is unlikely. Second, heat diffusion between a tissue’s structural collagen fibers and the surrounding water is expected to take place on quite short time scales – just a few ns for the 30-nm diameter fibers in cornea. Thus, an FEL macropulse is much too long (3-5 µs) to confine the deposited energy to its original water or protein compartment, i.e. too long to achieve microscale thermal confinement [16

16. V. Venugopalan, N. S. Nishioka, and B. B. Mikić, “Thermodynamic response of soft biological tissues to pulsed infrared-laser irradiation,” Biophys. J. 70(6), 2981–2993 (1996). [CrossRef] [PubMed]

].

2. Materials & methods

Corneas were obtained from sacrificed pig eyes within 24 hours post-mortem, swabbed with ethanol to remove the epithelial layer, and washed with distilled water to remove any contaminant on the surface. For each tissue sample, a strip of cornea and sclera (approximately 5 × 1 cm) was affixed over the internal opening of a metal substrate (razor blade) using cyanoacrylate glue applied to the edges of the strip. Special care was taken to ensure uniform tension on the sample and avoid any wrinkling of the surface. Corneal samples were periodically sprayed with saline, with the excess carefully blotted away, to maintain normal hydration. The thickness of the cornea was measured with a micrometer caliper.

2.1 Laser parameters

The Vanderbilt Mark-III FEL has a complex pulse structure in which 3-5 µs long macropulses are delivered at 1-30 Hz [23

23. J. M. J. Madey, “Stimulated Emission of Bremsstrahlung in a Periodic Magnetic Field,” J. Appl. Phys. 42(5), 1906–1930 (1971). [CrossRef]

]. Each macropulse is composed of a micropulse train: 1-ps long pulses at a repetition rate of 2.85 GHz. Note that all references to fluence in this report correspond to macropulse fluence. For each experiment, the FEL is tuned to a specific wavelength in the range 2-9 µm (with linewidth Δλ/λ ~2% FWHM). Measurements were conducted at a pulse repetition rate of 30 Hz (except single-pulse plume imaging).

At the experimental end station, the FEL exits an evacuated beam transport system with a 1/e 2 radius from 5 to 10 mm (wavelength-dependent) and a Rayleigh range in excess of 10 m. The beam is steered by three 3”-diameter silver-coated mirrors and traverses a large-aperture shutter (Uniblitz VS35S27M1, Vincent Associates, Rochester, NY), a wire-grid polarizer for fine energy control, an adjustable iris aperture, a CaF2 pickoff window that sends a small fraction of the beam (~10%) to an energy meter (Ophir PE50BB, Ophir-Spiricon, Logan, UT), and a planoconvex lens to focus the beam (CaF2, nominal f = 10, 15, 25 or 50 cm at λ = 5 µm; all optics from ISP Optics, Irvington, NY). A second energy meter was placed behind the sample. In some experiments, the wire grid was replaced with a Brewster angle polarizer.

2.2 Beam profile measurements

The intensity profile of the FEL beam was measured at multiple locations near the focus using a knife-edge technique. Measurements were made in two orthogonal directions at several points along the beam to calculate the focal plane, minimum beam waist and Rayleigh length. The FEL pulse energy was kept at 0.5 mJ during the profile measurement to avoid damage to the razor blade’s edge.

2.3 Etch depth measurements

Cornea samples were positioned such that the sample surface was at the FEL focal plane. These samples were generally thinner than the Rayleigh range of the focused beam (except for f = 10 cm). Each measurement consisted of measuring the number of pulses required to perforate the sample – detected by an energy meter placed behind the sample. The pre-perforation pulses were counted and measured by sending a small fraction of every pulse to a calibrated energy meter. Each perforation was conducted at a fresh spot on the sample, with a spot separation of 1 mm in both directions. Five to eight such perforations were measured for each set of laser parameters (wavelength, pulse energy and focused beam radius). The mean etch depth per pulse is the corneal thickness divided by the average number of pulses required for perforation. The results were subjected to nonlinear regression in Origin (OriginLab Corporation, Northampton, MA) and statistical analysis in Mathematica (Wolfram Research, Champaign, IL).

2.4 Histology for collateral damage analysis

Samples were mounted as above and most were exposed to FEL macropulses at a rate of 30 Hz while the sample was translated at 0.3 mm/s – resulting in a long, linear crater. For other samples, a linear crater was created by exposure to a fixed number of pulses at one location, translation by approximately half a beam diameter, and repeated exposure, with the cycle repeated dozens of times. Six to eight lines were cut into each cornea, with different macropulse fluence for each line. Ablated samples were fixed, imbedded in paraffin and sectioned at 6-µm intervals perpendicular to the tissue surface and the linear incision. Sections were mounted on 1 × 3 inch glass slides and stained with hematoxylin and eosin.

The crater morphology and zone of thermal injury were examined by bright-field microscopy. The darker areas along the edges of the crater are regions of thermal collateral damage [22

22. M. A. Mackanos, J. A. Kozub, D. L. Hachey, K. M. Joos, D. L. Ellis, and E. D. Jansen, “The effect of free-electron laser pulse structure on mid-infrared soft-tissue ablation: biological effects,” Phys. Med. Biol. 50(8), 1885–1899 (2005). [CrossRef] [PubMed]

]. The extent of these regions was quantified using ImageJ (NIH, Bethesda, MD). We first thresholded the contiguous dark region along the crater borders and then analyzed its thickness from 10% to 90% of the crater depth. The resulting distributions of collateral damage thickness were characterized in terms of their mean, median and quartile boundaries.

2.5 Plume imaging

Samples were mounted as described above, and the pulse energy was adjusted to maintain a constant fluence of 15 J/cm2. The ablation plume was imaged perpendicular to the FEL beam path using a nitrogen laser (LN1000, Laser Photonics LLC, Lake Mary, FL) coupled to a rhodamine dye module (Laser Photonics LN102) to produce a 4 ns pulse of light at λ = 644 nm. To reduce laser speckle and improve image quality, the laser was coupled into a 1-km long multimode optical fiber. A 25-mm planoconvex lens collimated the output from the fiber to produce a beam that passed in front of, and parallel to, the sample stage. The resulting image was focused onto the sensor of a color CCD camera (AVT Dolphin F145C, Allied Vision Technologies, Stadtroda, Germany) using a 105-mm zoom lens (Nikkor Telephoto AF, Nikon Co., Tokyo, Japan). A digital delay/pulse generator (SRS DG535, Stanford Research Systems, Sunnyvale, CA) and custom-built synchronization circuit were used to set the delay between the ablation and illumination lasers [22

22. M. A. Mackanos, J. A. Kozub, D. L. Hachey, K. M. Joos, D. L. Ellis, and E. D. Jansen, “The effect of free-electron laser pulse structure on mid-infrared soft-tissue ablation: biological effects,” Phys. Med. Biol. 50(8), 1885–1899 (2005). [CrossRef] [PubMed]

].

3. Results

To test the differential-absorption/partial-confinement model, we ablated porcine corneas with the FEL at a variety of wavelengths, spot-sizes and fluence. The chosen wavelengths were 2.77, 3.32, 5.97, 6.26 and 6.45 µm – five wavelengths for which cornea has matching absorption coefficients, but which differentially target protein and water (Table 1

Table 1. Effective absorption coefficient, α, for FEL irradiation of corneal stroma a – including estimates for its water and protein components.b

table-icon
View This Table
). Among these wavelengths, the model predicts no chromophore-dependence for the ablation metrics at low macropulse intensity – < 3 × 106 W/cm2, equivalent to a fluence of 15 J/cm2 [15

15. M. S. Hutson, and G. S. Edwards, “Advances in the Physical Understanding of Laser Surgery at 6.45 microns,” in 26th International Free Electron Laser Conference and 11th FEL Users Workshop (Trieste, Italy, 2003) paper: FRAIS01.

] – and an increasingly strong dependence at high fluence. In the high-fluence regime, wavelengths that target protein are predicted to have higher ablation efficiency and lower collateral damage. The experiments below cover a wide range of fluence, 5 to 250 J/cm2, and examine the ablation process in terms of etch depth, collateral damage and plume images.

3.1 Etch depth

As a first test, we measured the mean etch depth per pulse δ as a function of wavelength λ and single-pulse fluence Φ. Even within the matched set of wavelengths, the slope of δ(Φ) is highly chromophore-dependent. As shown in Fig. 1(a)
Fig. 1 Wavelength, fluence and spot-size dependence of the mean etch depth per pulse. (a) Several wavelengths with matched absorption coefficients. Each wavelength was focused with the same lens and thus has a different 1/e 2 radius at the beam waist (w, noted in the legend). Open (closed) symbols are used for predominantly protein- (water)-targeting wavelengths. (b) A single wavelength focused with several different lenses to yield different spot-sizes. (c, d) Two wavelengths with distinct differential absorption, but closely matched spot sizes. Error bars correspond to ± one standard deviation.
, the slope is much larger for the wavelengths that predominantly target protein modes (5.97, 6.26 and 6.45 µm). This larger slope indicates higher ablation efficiency.

At first glance, the data appear to strongly confirm the model predictions; however, these data were collected using a single focusing lens. The wavelength is thus tightly coupled with the focal spot size (w = 1/e 2 radius at the beam waist). To decouple λ and w, we collected additional data with different focal-length lenses. In some instances, we further varied w by placing a variable aperture before the lens. In this second data set, the slope of δ(Φ) is highly spot-size-dependent – even for a single wavelength. Results for λ = 2.77 µm are shown in Fig. 1(b). At the largest beam radius, this water-targeting wavelength has higher ablation efficiency than any of the protein-targeting wavelengths, but at the smallest beam radius, its efficiency is 1/10th as high. For protein-targeting wavelengths, the efficiency also decreases at smaller spot sizes, but in a much less drastic manner. One can see this effect in Fig. 1(a). Within the scatter of protein-targeting data, those points corresponding to the largest, middle and smallest spot sizes are on the corresponding high side, middle and low side of the range (open squares, circles and triangles respectively).

These observations raise an important question: how much of the apparent λ-dependence in Fig. 1(a) can be attributed to a coupled spot-size dependence? As a first test, we directly compare etch-depth measurements at different λ, but closely matched spot sizes. Even for the two wavelengths that appear most different in Fig. 1(a), 2.77 and 6.45 µm, measurements of δ(Φ) overlap strongly when both wavelengths are focused to w ~75 µm (Fig. 1(c)). An overlap also occurs at larger matched spot sizes (w ~125 µm), but we only have comparable data for Φ < 40 J/cm2. At the high end of this range, the measurements hint at some wavelength differences. We do not have direct comparisons for w < 70 µm.

As a second test, we used linear regression to estimate the slope, or ablation efficiency, of δ(Φ) for each w and λ in Fig. 1 plus several additional data sets (23 total). The efficiencies were then subjected to an analysis of covariance (ANCOVA) to determine whether there is a significant λ-dependence above and beyond the obvious spot-size dependence. ANCOVA was carried out using one factor – whether the wavelength dominantly targets protein or water – and one covariate, either F(w) = w or w 2. This makes the fitted model a + bF(w) + c*target, where target = 0 for protein-targeting wavelengths and target = 1 for water-targeting wavelengths. As expected, we find a highly significant dependence of ablation efficiency on either w or w 2 (P = 5 × 10−4 or 2 × 10−4). The data do not provide tight enough constraints to decide between these two forms of w-dependence; however, once the variance attributable to either F(w) is removed, there is no remaining dependence on the targeted chromophore (Ptarget = 0.35 when F(w) = w; 0.38 when F(w) = w 2).

The Hibst parameters were also subjected to ANCOVA, but with inverted covariates, either F(w) = 1/w or 1/w 2. We find a very significant dependence of h abl on 1/w 2 (P = 9 × 10−8). One could make a similar statement with regard to 1/w, but that best fit yields an unphysical result – specifically h abl < 0 at large spot sizes. In any case, once the variance attributable to spot-size is removed, there is again no remaining dependence on the targeted chromophore (Ptarget = 0.94 for F(w) = 1/w 2). This result is shown graphically in Fig. 2(a), where the best-fit curves for each factor level strongly overlap – so strongly that it is difficult to see the two lines separately (a = 54 ± 430 J/g, b = 15 ± 1.9 × 106 J µm2/g and c = −34 ± 450 J/g). From these results, we conclude that the apparent λ-dependence in Fig. 1 is really just a proxy for an underlying w-dependence.

Similar ANCOVA for Φth is much less definitive. It indicates a slightly significant dependence on 1/w 2 (P = 0.02), and a slightly insignificant dependence on the targeted chromophore (Ptarget = 0.07). In the entire set of etch depth data, this borderline result is the only one with any dependence on the targeted chromophore.

3.2 Collateral damage

As a second test, we measured thermomechanical collateral damage after ablating corneas at 2.77 and 6.45 µm, the two matching wavelengths with the largest difference in differential absorption. Noting the significant w-dependence above, we initially limited these experiments to matching 50-µm spot sizes at the tissue surface. The minimum beam waist was still λ-dependent – 36 versus 50 µm at λ = 2.77 or 6.45 µm respectively – so the tissue surface was positioned about 400 µm from the 2.77-µm beam waist. The fluence was thus matched at the tissue surface, but differed by a factor of two when averaged over the tissue thickness.

To see if there was any w-dependence, we also measured the Δ-distributions for larger 90-µm spots. As shown in Fig. 3(c), the damage widths at both spot sizes generally fall along the same trend versus fluence. Interestingly, at the larger spot size, the damage width no longer has a significant λ-dependence at low fluence (P > 0.1 at both 12 and 60 J/cm2). In Fig. 3(d), we compile the Δ-distributions for several experiments with similar fluence (50-60 J/cm2), but variable spot sizes. The damage has no clear trend with either λ or w.

Importantly, these same histological images confirm a w-dependence for the etch depth. Using just three pulses at λ = 2.77 µm, Φ = 60 J/cm2 and w = 50 or 90 µm, the larger spot size yielded craters that were >3 × deeper (680 ± 190 versus 180 ± 60 µm). In both cases, the crater width was approximately twice the spot diameter.

3.3 Plume imaging

As a final metric and as a way to investigate the observed spot-size effects, we took images of the ablation plume from 300 ns to 1 ms after the start of the FEL pulse. Image sets were collected for λ = 2.77 and 6.45 µm with three different lenses (f = 15, 25 and 50 cm) and with the pulse energy adjusted to yield a constant fluence of 15 J/cm2. In each case, the images revealed a pressure wave followed by a vapor/particulate plume (Fig. 4
Fig. 4 Bright-field images of the pressure wave and vapor/debris plume during FEL ablation of cornea at Φ = 15 J/cm2 and λ = 2.77 µm (top) or 6.45 µm (bottom). Each 3 × 3 set of images has columns for different focusing lenses (nominal f = 15, 25 and 50 cm) and rows for different times after the rising edge of the laser pulse (3, 10 and 30 µs). The scale bar at the top left of each image group represents 1 mm. The horizontal bar at the bottom center of each image denotes the measured beam diameter at the tissue surface.
). The plume was clearly evident by 2-3 µs – well before the end of the FEL macropulse – and dissipated within 100 µs. In a few cases, the 30- and 100-µs images showed a secondary plume from recoil-induced ejection (e.g. 30-µs panel for λ = 6.45 µm and f = 50 cm). The images are very similar to those observed from many examples of photothermal ablation – including ablation of water with an FEL; however, water ablation yielded a longer-lasting plume with much more secondary ejection [22

22. M. A. Mackanos, J. A. Kozub, D. L. Hachey, K. M. Joos, D. L. Ellis, and E. D. Jansen, “The effect of free-electron laser pulse structure on mid-infrared soft-tissue ablation: biological effects,” Phys. Med. Biol. 50(8), 1885–1899 (2005). [CrossRef] [PubMed]

].

We find no discernable λ- or w-dependence for the particulate content of the initial plume, for the speed of the pressure wave (332 ± 14 m/s) or for the initial expansion rate of the plume (156 ± 13 m/s). The only observable that did vary was the likelihood of secondary ejection. This likelihood increased with spot-size. At Φ = 15 J/cm2, secondary ejection was always evident for w > 100 µm, but was only evident in 1 of 4 experiments with smaller spots.

4. Discussion

Interestingly, the ablation metrics presented here clearly depend on fluence and spot-size. At constant w, both etch depth and collateral damage increase with fluence. At constant Φ, etch depth decreases as spot-size decreases, but collateral damage does not change. The fluence dependence is as expected, but the spot-size dependence is a bit surprising. Although similar spot-size effects have been noted in a few instances [27

27. Y. Domankevitz, M. S. Lee, and N. S. Nishioka, “Effects of irradiance and spot size on pulsed holmium laser ablation of tissue,” Appl. Opt. 32(4), 569–573 (1993). [CrossRef] [PubMed]

29

29. U. S. Sathyam, A. Shearin, E. A. Chasteney, and S. A. Prahl, “Threshold and ablation efficiency studies of microsecond ablation of gelatin under water,” Lasers Surg. Med. 19(4), 397–406 (1996). [CrossRef] [PubMed]

], most ablation studies implicitly assume that making constant fluence comparisons eliminates spot-size effects. In the present data, that assumption is clearly not valid.

The data presented here on spot-size dependence are not sufficient to pinpoint an exact mechanism. The literature contains many theoretical and empirical examples of spot-size dependencies in ablation, for example:

  • A. scattering of more photons out of tightly focused spots [30

    30. R. R. Anderson and J. A. Parrish, “The optics of human skin,” J. Invest. Dermatol. 77(1), 13–19 (1981). [CrossRef] [PubMed]

    ];
  • B. increased plume shielding at larger spots [31

    31. B. Wolff-Rottke, J. Ihlemann, H. Schmidt, and A. Scholl, “Influence of the laser spot diameter on photo-ablation rates,” Appl. Phys., A Mater. Sci. Process. 60(1), 13–17 (1995). [CrossRef]

    ,32

    32. M. Eyett and D. Bauerle, “Influence of the Beam Spot Size on Ablation Rates in Pulsed-Laser Processing,” Appl. Phys. Lett. 51(24), 2054–2055 (1987). [CrossRef]

    ];
  • C. increased loss of energy density in small spots due to heat conduction [33

    33. F. Partovi, J. A. Izatt, R. M. Cothren, C. Kittrell, J. E. Thomas, S. Strikwerda, J. R. Kramer, and M. S. Feld, “A model for thermal ablation of biological tissue using laser radiation,” Lasers Surg. Med. 7(2), 141–154 (1987). [CrossRef] [PubMed]

    ];
  • D. influence of tissue curvature on the pressure head needed to stretch the tissue to tensile failure [34

    34. B. Majaron, P. Plestenjak, and M. Lukac, “Thermo-mechanical laser ablation of soft biological tissue: modeling the micro-explosions,” Appl. Phys. B 69, 71–80 (1999). [CrossRef]

    ]; and
  • E. influence of crater aspect ratio on the hydrodynamics of post-pulse ablation [35

    35. A. Vogel, I. Apitz, and V. Venugopalan, “Phase transitions, material ejection, and plume dynamics in pulsed laser ablation of soft biological tissues,” in Oscillations, Waves and Interactions, T. Kurz, U. Parlitz, and U. Kaatze, eds. (Universitätsverlag Göttingen, Göttingen, 2007), pp. 217–258.

    37

    37. A. D. Zweig, “A thermo-mechanical model for laser ablation,” J. Appl. Phys. 70(3), 1684–1691 (1991). [CrossRef]

    ].

Acknowledgements

The authors thank Prof. Glenn Edwards for reviewing an early version of the manuscript and the staff of the W. M. Keck Vanderbilt Free-electron Laser Center for generously providing beam time and expertise to this project. This work was supported by: grants FA9550-04-1-0045 and FA9620-00-1-0370 from the DoD Medical FEL Program; NSF/HRD grant No. 0420516 (CREST); and by the NSF Center for Biophotonics, managed by U.C. Davis, CA No. PHY0120999.

References and links

1.

G. Edwards, R. Logan, M. Copeland, L. Reinisch, J. Davidson, B. Johnson, R. Maciunas, M. Mendenhall, R. Ossoff, J. Tribble, J. Werkhaven, and D. O'Day, “Tissue ablation by a free-electron laser tuned to the amide II band,” Nature 371(6496), 416–419 (1994). [CrossRef] [PubMed]

2.

J. I. Youn, P. Sweet, G. M. Peavy, and V. Venugopalan, “Mid-IR laser ablation of articular and fibro-cartilage: a wavelength dependence study of thermal injury and crater morphology,” Lasers Surg. Med. 38(3), 218–228 (2006). [CrossRef] [PubMed]

3.

K. M. Joos, J. H. Shen, D. J. Shetlar, and V. A. Casagrande, “Optic nerve sheath fenestration with a novel wavelength produced by the free electron laser (FEL),” Lasers Surg. Med. 27(3), 191–205 (2000). [CrossRef] [PubMed]

4.

R. A. Hill, Q. Ren, D. C. Nguyen, L. H. Liaw, and M. W. Berns, “Free-electron laser (FEL) ablation of ocular tissues,” Lasers Med. Sci. 13(3), 219–226 (1998). [CrossRef]

5.

R. Kaufmann and R. Hibst, “Pulsed erbium:YAG laser ablation in cutaneous surgery,” Lasers Surg. Med. 19(3), 324–330 (1996). [CrossRef] [PubMed]

6.

R. Cubeddu, C. Sozzi, P. Taroni, G. Valentini, G. Bottiroli, and A. C. Croce, “Study of mechanical and thermal damage in brain tissue after ablation by Erbium-YAG laser,” Lasers Med. Sci. 12(1), 21–30 (1997). [CrossRef]

7.

T. S. Alster, “Clinical and histologic evaluation of six erbium:YAG lasers for cutaneous resurfacing,” Lasers Surg. Med. 24(2), 87–92 (1999). [CrossRef] [PubMed]

8.

J. Kiefer, J. Tillein, Q. Ye, R. Klinke, and W. Gstoettner, “Application of carbon dioxide and erbium:yttrium-aluminum-garnet lasers in inner ear surgery: an experimental study,” Otol. Neurotol. 25(3), 400–409 (2004). [CrossRef] [PubMed]

9.

G. S. Edwards, R. H. Austin, F. E. Carroll, M. L. Copeland, M. E. Couprie, W. E. Gabella, R. F. Haglund, B. A. Hooper, M. S. Hutson, E. D. Jansen, K. M. Joos, D. P. Kiehart, I. Lindau, J. Miao, H. S. Pratisto, J. H. Shen, Y. Tokutake, A. F. G. van der Meer, and A. Xie, “Free-electron-laser-based biophysical and biomedical instrumentation,” Rev. Sci. Instrum. 74(7), 3207–3245 (2003). [CrossRef]

10.

M. L. Copeland, R. J. Maciunas, and G. S. Edwards, “Chapter VII,” in Neurosurgical Topics: Advanced Techniques in Central Nervous System Metastases, R. J. Maciunas, ed. (The American Association of Neurological Surgeons, Park Ridge, IL, 1998).

11.

G. S. Edwards, R. D. Pearlstein, M. L. Copeland, M. S. Hutson, K. Latone, A. Spiro, and G. Pasmanik, “6450 nm wavelength tissue ablation using a nanosecond laser based on difference frequency mixing and stimulated Raman scattering,” Opt. Lett. 32(11), 1426–1428 (2007). [CrossRef] [PubMed]

12.

M. A. Mackanos, D. Simanovskii, K. M. Joos, H. A. Schwettman, and E. D. Jansen, “Mid infrared optical parametric oscillator (OPO) as a viable alternative to tissue ablation with the free electron laser (FEL),” Lasers Surg. Med. 39(3), 230–236 (2007). [CrossRef] [PubMed]

13.

M. S. Hutson, S. A. Hauger, and G. Edwards, “Thermal diffusion and chemical kinetics in laminar biomaterial due to heating by a free-electron laser,” Phys. Rev. E Stat. Nonlin. Soft Matter Phys. 65(6 Pt 1), 061906 (2002). [CrossRef] [PubMed]

14.

G. S. Edwards and M. S. Hutson, “Advantage of the Mark-III FEL for biophysical research and biomedical applications,” J. Synchrotron Radiat. 10(5), 354–357 (2003). [CrossRef] [PubMed]

15.

M. S. Hutson, and G. S. Edwards, “Advances in the Physical Understanding of Laser Surgery at 6.45 microns,” in 26th International Free Electron Laser Conference and 11th FEL Users Workshop (Trieste, Italy, 2003) paper: FRAIS01.

16.

V. Venugopalan, N. S. Nishioka, and B. B. Mikić, “Thermodynamic response of soft biological tissues to pulsed infrared-laser irradiation,” Biophys. J. 70(6), 2981–2993 (1996). [CrossRef] [PubMed]

17.

J. Tribble, D. C. Lamb, L. Reinisch, and G. Edwards, “Dynamics of gelatin ablation due to free-electron-laser irradiation,” Phys. Rev. E Stat. Phys. Plasmas Fluids Relat. Interdiscip. Topics 55(6), 7385–7389 (1997). [CrossRef]

18.

W. Wagner, A. Sokolow, R. D. Pearlstein, and G. S. Edwards, “Thermal vapor bubble and pressure dynamics during infrared laser ablation of tissue,” Appl. Phys. Lett. 94(1), 013901 (2009). [CrossRef]

19.

Y. W. Xiao, M. S. Guo, K. Parker, and M. S. Hutson, “Wavelength-dependent collagen fragmentation during mid-IR laser ablation,” Biophys. J. 91(4), 1424–1432 (2006). [CrossRef] [PubMed]

20.

Y. Xiao, M. Guo, P. Zhang, G. Shanmugam, P. L. Polavarapu, and M. S. Hutson, “Wavelength-dependent conformational changes in collagen after mid-infrared laser ablation of cornea,” Biophys. J. 94(4), 1359–1366 (2008). [CrossRef]

21.

M. A. Mackanos, J. A. Kozub, and E. D. Jansen, “The effect of free-electron laser pulse structure on mid-infrared soft-tissue ablation: ablation metrics,” Phys. Med. Biol. 50(8), 1871–1883 (2005). [CrossRef] [PubMed]

22.

M. A. Mackanos, J. A. Kozub, D. L. Hachey, K. M. Joos, D. L. Ellis, and E. D. Jansen, “The effect of free-electron laser pulse structure on mid-infrared soft-tissue ablation: biological effects,” Phys. Med. Biol. 50(8), 1885–1899 (2005). [CrossRef] [PubMed]

23.

J. M. J. Madey, “Stimulated Emission of Bremsstrahlung in a Periodic Magnetic Field,” J. Appl. Phys. 42(5), 1906–1930 (1971). [CrossRef]

24.

A. Vogel and V. Venugopalan, “Mechanisms of pulsed laser ablation of biological tissues,” Chem. Rev. 103(2), 577–644 (2003). [CrossRef] [PubMed]

25.

W. B. Telfair, C. Bekker, H. J. Hoffman, P. R. Yoder Jr, R. E. Nordquist, R. A. Eiferman, and H. H. Zenzie, “Histological comparison of corneal ablation with Er:YAG laser, Nd:YAG optical parametric oscillator, and excimer laser,” J. Refract. Surg. 16(1), 40–50 (2000). [PubMed]

26.

B. P. Payne, N. S. Nishioka, B. B. Mikic, and V. Venugopalan, “Comparison of pulsed CO2 laser ablation at 10.6 μm and 9.5 μm,” Lasers Surg. Med. 23(1), 1–6 (1998). [CrossRef] [PubMed]

27.

Y. Domankevitz, M. S. Lee, and N. S. Nishioka, “Effects of irradiance and spot size on pulsed holmium laser ablation of tissue,” Appl. Opt. 32(4), 569–573 (1993). [CrossRef] [PubMed]

28.

U. S. Sathyam, A. Shearin, and S. A. Prahl, “The effects of spot size, pulse energy, and repetition rate on microsecond ablation of gelatin under water,” Proc. SPIE-Int. Soc. Opt. Eng. 2391, 336–344 (1995).

29.

U. S. Sathyam, A. Shearin, E. A. Chasteney, and S. A. Prahl, “Threshold and ablation efficiency studies of microsecond ablation of gelatin under water,” Lasers Surg. Med. 19(4), 397–406 (1996). [CrossRef] [PubMed]

30.

R. R. Anderson and J. A. Parrish, “The optics of human skin,” J. Invest. Dermatol. 77(1), 13–19 (1981). [CrossRef] [PubMed]

31.

B. Wolff-Rottke, J. Ihlemann, H. Schmidt, and A. Scholl, “Influence of the laser spot diameter on photo-ablation rates,” Appl. Phys., A Mater. Sci. Process. 60(1), 13–17 (1995). [CrossRef]

32.

M. Eyett and D. Bauerle, “Influence of the Beam Spot Size on Ablation Rates in Pulsed-Laser Processing,” Appl. Phys. Lett. 51(24), 2054–2055 (1987). [CrossRef]

33.

F. Partovi, J. A. Izatt, R. M. Cothren, C. Kittrell, J. E. Thomas, S. Strikwerda, J. R. Kramer, and M. S. Feld, “A model for thermal ablation of biological tissue using laser radiation,” Lasers Surg. Med. 7(2), 141–154 (1987). [CrossRef] [PubMed]

34.

B. Majaron, P. Plestenjak, and M. Lukac, “Thermo-mechanical laser ablation of soft biological tissue: modeling the micro-explosions,” Appl. Phys. B 69, 71–80 (1999). [CrossRef]

35.

A. Vogel, I. Apitz, and V. Venugopalan, “Phase transitions, material ejection, and plume dynamics in pulsed laser ablation of soft biological tissues,” in Oscillations, Waves and Interactions, T. Kurz, U. Parlitz, and U. Kaatze, eds. (Universitätsverlag Göttingen, Göttingen, 2007), pp. 217–258.

36.

I. Apitz and A. Vogel, “Material ejection in nanosecond Er:YAG laser ablation of water, liver and skin,” Appl. Phys., A Mater. Sci. Process. 81(2), 329–338 (2005). [CrossRef]

37.

A. D. Zweig, “A thermo-mechanical model for laser ablation,” J. Appl. Phys. 70(3), 1684–1691 (1991). [CrossRef]

38.

J. P. Cummings and J. T. Walsh Jr., “Tissue tearing caused by pulsed laser-induced ablation pressure,” Appl. Opt. 32(4), 494 (1993). [CrossRef] [PubMed]

39.

J. I. Youn, P. Sweet, and G. M. Peavy, “A comparison of mass removal, thermal injury, and crater morphology of cortical bone ablation using wavelengths 2.79, 2.9, 6.1, and 6.45 microm,” Lasers Surg. Med. 39(4), 332–340 (2007). [CrossRef] [PubMed]

40.

J. M. Auerhammer, R. Walker, A. F. G. van der Meer, and B. Jean, “Dynamic behavior of photoablation products of corneal tissue in the mid-IR: a study with FELIX,” Appl. Phys. B 68(1), 111–119 (1999). [CrossRef]

OCIS Codes
(140.2600) Lasers and laser optics : Free-electron lasers (FELs)
(170.1020) Medical optics and biotechnology : Ablation of tissue

ToC Category:
Medical Optics and Biotechnology

History
Original Manuscript: April 1, 2009
Revised Manuscript: May 18, 2009
Manuscript Accepted: May 20, 2009
Published: May 27, 2009

Virtual Issues
Vol. 4, Iss. 8 Virtual Journal for Biomedical Optics

Citation
M. Shane Hutson, Borislav Ivanov, Aroshan Jayasinghe, Gilma Adunas, Yaowu Xiao, Mingsheng Guo, and John Kozub, "Interplay of wavelength, fluence and spot-size in free-electron laser ablation of cornea," Opt. Express 17, 9840-9850 (2009)
http://www.opticsinfobase.org/vjbo/abstract.cfm?URI=oe-17-12-9840


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References

  1. G. Edwards, R. Logan, M. Copeland, L. Reinisch, J. Davidson, B. Johnson, R. Maciunas, M. Mendenhall, R. Ossoff, J. Tribble, J. Werkhaven, and D. O'Day, “Tissue ablation by a free-electron laser tuned to the amide II band,” Nature 371(6496), 416–419 (1994). [CrossRef] [PubMed]
  2. J. I. Youn, P. Sweet, G. M. Peavy, and V. Venugopalan, “Mid-IR laser ablation of articular and fibro-cartilage: a wavelength dependence study of thermal injury and crater morphology,” Lasers Surg. Med. 38(3), 218–228 (2006). [CrossRef] [PubMed]
  3. K. M. Joos, J. H. Shen, D. J. Shetlar, and V. A. Casagrande, “Optic nerve sheath fenestration with a novel wavelength produced by the free electron laser (FEL),” Lasers Surg. Med. 27(3), 191–205 (2000). [CrossRef] [PubMed]
  4. R. A. Hill, Q. Ren, D. C. Nguyen, L. H. Liaw, and M. W. Berns, “Free-electron laser (FEL) ablation of ocular tissues,” Lasers Med. Sci. 13(3), 219–226 (1998). [CrossRef]
  5. R. Kaufmann and R. Hibst, “Pulsed erbium:YAG laser ablation in cutaneous surgery,” Lasers Surg. Med. 19(3), 324–330 (1996). [CrossRef] [PubMed]
  6. R. Cubeddu, C. Sozzi, P. Taroni, G. Valentini, G. Bottiroli, and A. C. Croce, “Study of mechanical and thermal damage in brain tissue after ablation by Erbium-YAG laser,” Lasers Med. Sci. 12(1), 21–30 (1997). [CrossRef]
  7. T. S. Alster, “Clinical and histologic evaluation of six erbium:YAG lasers for cutaneous resurfacing,” Lasers Surg. Med. 24(2), 87–92 (1999). [CrossRef] [PubMed]
  8. J. Kiefer, J. Tillein, Q. Ye, R. Klinke, and W. Gstoettner, “Application of carbon dioxide and erbium:yttrium-aluminum-garnet lasers in inner ear surgery: an experimental study,” Otol. Neurotol. 25(3), 400–409 (2004). [CrossRef] [PubMed]
  9. G. S. Edwards, R. H. Austin, F. E. Carroll, M. L. Copeland, M. E. Couprie, W. E. Gabella, R. F. Haglund, B. A. Hooper, M. S. Hutson, E. D. Jansen, K. M. Joos, D. P. Kiehart, I. Lindau, J. Miao, H. S. Pratisto, J. H. Shen, Y. Tokutake, A. F. G. van der Meer, and A. Xie, “Free-electron-laser-based biophysical and biomedical instrumentation,” Rev. Sci. Instrum. 74(7), 3207–3245 (2003). [CrossRef]
  10. M. L. Copeland, R. J. Maciunas, and G. S. Edwards, “Chapter VII,” in Neurosurgical Topics: Advanced Techniques in Central Nervous System Metastases, R. J. Maciunas, ed. (The American Association of Neurological Surgeons, Park Ridge, IL, 1998).
  11. G. S. Edwards, R. D. Pearlstein, M. L. Copeland, M. S. Hutson, K. Latone, A. Spiro, and G. Pasmanik, “6450 nm wavelength tissue ablation using a nanosecond laser based on difference frequency mixing and stimulated Raman scattering,” Opt. Lett. 32(11), 1426–1428 (2007). [CrossRef] [PubMed]
  12. M. A. Mackanos, D. Simanovskii, K. M. Joos, H. A. Schwettman, and E. D. Jansen, “Mid infrared optical parametric oscillator (OPO) as a viable alternative to tissue ablation with the free electron laser (FEL),” Lasers Surg. Med. 39(3), 230–236 (2007). [CrossRef] [PubMed]
  13. M. S. Hutson, S. A. Hauger, and G. Edwards, “Thermal diffusion and chemical kinetics in laminar biomaterial due to heating by a free-electron laser,” Phys. Rev. E Stat. Nonlin. Soft Matter Phys. 65(6 Pt 1), 061906 (2002). [CrossRef] [PubMed]
  14. G. S. Edwards and M. S. Hutson, “Advantage of the Mark-III FEL for biophysical research and biomedical applications,” J. Synchrotron Radiat. 10(5), 354–357 (2003). [CrossRef] [PubMed]
  15. M. S. Hutson, and G. S. Edwards, “Advances in the Physical Understanding of Laser Surgery at 6.45 microns,” in 26th International Free Electron Laser Conference and 11th FEL Users Workshop (Trieste, Italy, 2003) paper: FRAIS01.
  16. V. Venugopalan, N. S. Nishioka, and B. B. Mikić, “Thermodynamic response of soft biological tissues to pulsed infrared-laser irradiation,” Biophys. J. 70(6), 2981–2993 (1996). [CrossRef] [PubMed]
  17. J. Tribble, D. C. Lamb, L. Reinisch, and G. Edwards, “Dynamics of gelatin ablation due to free-electron-laser irradiation,” Phys. Rev. E Stat. Phys. Plasmas Fluids Relat. Interdiscip. Topics 55(6), 7385–7389 (1997). [CrossRef]
  18. W. Wagner, A. Sokolow, R. D. Pearlstein, and G. S. Edwards, “Thermal vapor bubble and pressure dynamics during infrared laser ablation of tissue,” Appl. Phys. Lett. 94(1), 013901 (2009). [CrossRef]
  19. Y. W. Xiao, M. S. Guo, K. Parker, and M. S. Hutson, “Wavelength-dependent collagen fragmentation during mid-IR laser ablation,” Biophys. J. 91(4), 1424–1432 (2006). [CrossRef] [PubMed]
  20. Y. Xiao, M. Guo, P. Zhang, G. Shanmugam, P. L. Polavarapu, and M. S. Hutson, “Wavelength-dependent conformational changes in collagen after mid-infrared laser ablation of cornea,” Biophys. J. 94(4), 1359–1366 (2008). [CrossRef]
  21. M. A. Mackanos, J. A. Kozub, and E. D. Jansen, “The effect of free-electron laser pulse structure on mid-infrared soft-tissue ablation: ablation metrics,” Phys. Med. Biol. 50(8), 1871–1883 (2005). [CrossRef] [PubMed]
  22. M. A. Mackanos, J. A. Kozub, D. L. Hachey, K. M. Joos, D. L. Ellis, and E. D. Jansen, “The effect of free-electron laser pulse structure on mid-infrared soft-tissue ablation: biological effects,” Phys. Med. Biol. 50(8), 1885–1899 (2005). [CrossRef] [PubMed]
  23. J. M. J. Madey, “Stimulated Emission of Bremsstrahlung in a Periodic Magnetic Field,” J. Appl. Phys. 42(5), 1906–1930 (1971). [CrossRef]
  24. A. Vogel and V. Venugopalan, “Mechanisms of pulsed laser ablation of biological tissues,” Chem. Rev. 103(2), 577–644 (2003). [CrossRef] [PubMed]
  25. W. B. Telfair, C. Bekker, H. J. Hoffman, P. R. Yoder, R. E. Nordquist, R. A. Eiferman, and H. H. Zenzie, “Histological comparison of corneal ablation with Er:YAG laser, Nd:YAG optical parametric oscillator, and excimer laser,” J. Refract. Surg. 16(1), 40–50 (2000). [PubMed]
  26. B. P. Payne, N. S. Nishioka, B. B. Mikic, and V. Venugopalan, “Comparison of pulsed CO2 laser ablation at 10.6 μm and 9.5 μm,” Lasers Surg. Med. 23(1), 1–6 (1998). [CrossRef] [PubMed]
  27. Y. Domankevitz, M. S. Lee, and N. S. Nishioka, “Effects of irradiance and spot size on pulsed holmium laser ablation of tissue,” Appl. Opt. 32(4), 569–573 (1993). [CrossRef] [PubMed]
  28. U. S. Sathyam, A. Shearin, and S. A. Prahl, “The effects of spot size, pulse energy, and repetition rate on microsecond ablation of gelatin under water,” Proc. SPIE-Int. Soc. Opt. Eng. 2391, 336–344 (1995).
  29. U. S. Sathyam, A. Shearin, E. A. Chasteney, and S. A. Prahl, “Threshold and ablation efficiency studies of microsecond ablation of gelatin under water,” Lasers Surg. Med. 19(4), 397–406 (1996). [CrossRef] [PubMed]
  30. R. R. Anderson and J. A. Parrish, “The optics of human skin,” J. Invest. Dermatol. 77(1), 13–19 (1981). [CrossRef] [PubMed]
  31. B. Wolff-Rottke, J. Ihlemann, H. Schmidt, and A. Scholl, “Influence of the laser spot diameter on photo-ablation rates,” Appl. Phys., A Mater. Sci. Process. 60(1), 13–17 (1995). [CrossRef]
  32. M. Eyett and D. Bauerle, “Influence of the Beam Spot Size on Ablation Rates in Pulsed-Laser Processing,” Appl. Phys. Lett. 51(24), 2054–2055 (1987). [CrossRef]
  33. F. Partovi, J. A. Izatt, R. M. Cothren, C. Kittrell, J. E. Thomas, S. Strikwerda, J. R. Kramer, and M. S. Feld, “A model for thermal ablation of biological tissue using laser radiation,” Lasers Surg. Med. 7(2), 141–154 (1987). [CrossRef] [PubMed]
  34. B. Majaron, P. Plestenjak, and M. Lukac, “Thermo-mechanical laser ablation of soft biological tissue: modeling the micro-explosions,” Appl. Phys. B 69, 71–80 (1999). [CrossRef]
  35. A. Vogel, I. Apitz, and V. Venugopalan, “Phase transitions, material ejection, and plume dynamics in pulsed laser ablation of soft biological tissues,” in Oscillations, Waves and Interactions, T. Kurz, U. Parlitz, and U. Kaatze, eds. (Universitätsverlag Göttingen, Göttingen, 2007), pp. 217–258.
  36. I. Apitz and A. Vogel, “Material ejection in nanosecond Er:YAG laser ablation of water, liver and skin,” Appl. Phys., A Mater. Sci. Process. 81(2), 329–338 (2005). [CrossRef]
  37. A. D. Zweig, “A thermo-mechanical model for laser ablation,” J. Appl. Phys. 70(3), 1684–1691 (1991). [CrossRef]
  38. J. P. Cummings and J. T. Walsh., “Tissue tearing caused by pulsed laser-induced ablation pressure,” Appl. Opt. 32(4), 494 (1993). [CrossRef] [PubMed]
  39. J. I. Youn, P. Sweet, and G. M. Peavy, “A comparison of mass removal, thermal injury, and crater morphology of cortical bone ablation using wavelengths 2.79, 2.9, 6.1, and 6.45 microm,” Lasers Surg. Med. 39(4), 332–340 (2007). [CrossRef] [PubMed]
  40. J. M. Auerhammer, R. Walker, A. F. G. van der Meer, and B. Jean, “Dynamic behavior of photoablation products of corneal tissue in the mid-IR: a study with FELIX,” Appl. Phys. B 68(1), 111–119 (1999). [CrossRef]

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