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Technische Prinzipien

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Refraktive Chirurgie

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Zusammenfassung

Beim Laser („light amplification by stimulated emission of radiation“) handelt es sich um eine Lichtquelle, die aufgrund der guten Fokussierbarkeit und der Möglichkeit, sehr kurze Pulse zu erzeugen, nicht nur hohe Leistungen, sondern auch extrem hohe Intensitäten (Leistungsdichten) generieren kann (Tab. 9.1). Je nach Laserparameter können unterschiedliche Arten von Wechselwirkungen auftreten und das Gewebe bei der Bestrahlung gezielt verändern (Abb. 9.1). Zu den Wechselwirkungsprozessen gehören: photochemische Wechselwirkungen, Koagulation und Vaporisation sowie die Photoablation und Photodisruption.

Sowohl die Photoablation als auch die Photodisruption spielen in der refraktiven Chirurgie eine entscheidende Rolle.

Anfang der 1980er-Jahre beschrieben Srinivasan und Mitarbeiter erstmalig ein Verfahren zur Bearbeitung organischer Polymere mit Hilfe von ultravioletter Excimerlaserstrahlung. Kennzeichnend für den neuartigen Prozess der Materialabtragung war die Verwendung von gepulster, energiereicher UV-Strahlung. Aufgrund der geringen Eindringtiefe der UV-Strahlung in die zu bearbeitenden Materialproben war es möglich, Strukturen im Sub-Mikrometerbereich in die organische Matrix zu ätzen. Srinivasan bezeichnete dieses Phänomen als „ablative Photodekomposition“. Den Abtragprozess erklärte man sich durch ein direktes Aufbrechen der Molekülbindungen der organischen Polymere, das durch die Absorption der energiereichen UV-Photonen hervorgerufen wurde.

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Authors and Affiliations

  1. Klinik für Augenheilkunde, Goethe Universität, Universitätsklinikum Frankfurt, Frankfurt am Main, Deutschland

    Univ.-Prof. Dr. Thomas Kohnen

  2. ROWIAK GmbH, Hannover, Deutschland

    Prof. Dr. Holger Lubatschowski

  3. Institut für Angewandte Optik und Elektronik, Technische Hochschule Köln, Campus Deutz, Köln, Deutschland

    Prof. Dr. Uwe Oberheide

  4. Prof. Kook & Partner, Augenarztpraxis, Gräfelfing, Deutschland

    Prof. Dr. Daniel Kook

  5. IROC AG, Zürich, Schweiz

    Prof. Dr. Michael Mrochen, Dr. Tobias Koller & Prof. Dr. Dr. Theo Seiler

  6. Department für Physik, Universität Paderborn, Paderborn, Deutschland

    Prof. Dr. Stefan Schumacher

  7. Wien, Österreich

    Prim. Univ. Prof. Dr. Günther Grabner

  8. Augenklinik, Universitätsklinikum Bochum, Bochum, Deutschland

    PD Dr. Tim Schultz

  9. North Potomac, Maryland, USA

    Ronald D. Gerste

  10. Augenklinik, Universitätsklinikum Bochum, 44892, Bochum, Deutschland

    Univ.-Prof. Dr. Burkhard Dick

  11. Klinik für Augenheilkunde, Goethe Universität, Universitätsklinikum Frankfurt, Frankfurt am Main, Deutschland

    Titus Schug

  12. EuroEyes alz, Augenklinik München, München, Deutschland

    Prof. Dr. Thomas Neuhann

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  1. Univ.-Prof. Dr. Thomas Kohnen
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  14. Prof. Dr. Thomas Neuhann
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Correspondence to Thomas Kohnen .

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  1. Zentrum für Augenheilkunde, Universitätklinikum Frankfurt, Frankfurt am Main, Deutschland

    Thomas Kohnen

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Kohnen, T. et al. (2023). Technische Prinzipien. In: Kohnen, T. (eds) Refraktive Chirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-60946-0_9

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