The free electron laser: a system capable of determining the gold standard in laser vision correction

Introduction. In laser vision correction surgery, lasers are generally utilized based on their beam-tissue interactions and corneal absorption characteristics. Therefore, the free electron laser, with its ability to provide broad wavelength tunability, is a unique research tool for investigating wavelengths of possible corneal ablation. Methods. Mark III free electron laser wavelengths between 2.94 and 6.7 μm were delivered in serial 0.1 μm intervals to corneas of freshly enucleated porcine globes. Collateral damage, ablation depth, and ablation diameter were measured in histologic sections. Results. The least collateral damage (12–13 μm) was demonstrated at three wavelengths: 6.0, 6.1 (amide I), and 6.3 μm. Minimal collateral damage (15 μm) was noted at 2.94 μm (OH-stretch) and at 6.2 μm. Slightly greater collateral damage was noted at 6.45 μm (amide II), as well as at the 5.5–5.7 μm range, but this was still substantially less than the collateral damage noted at the other wavelengths tested. Conclusions. Our results suggest that select mid-infrared wavelengths have potential for keratorefractive surgery and warrant additional study. Further, the free electron laserʹs ability to allow parameter adjustment in the far-ultraviolet spectrum may provide unprecedented insights toward establishing the gold-standard parameters for laser vision correction surgery.