Quantitative and ultrastructural studies of excimer laser ablation of the cornea at 193 and 248 nanometers

Excimer laser radiation at 193 nm and 248 nm was used to create linear etch perforations of enucleated calf corneas. The etch depth per pulse was determined for various exposures, and specimens were examined by light and transmission electron microscopy. Compared to 248 nm, excimer laser ablation at 193 nm was found to have a lower threshold for onset of ablation, less increase in etch depth per pulse at increasing fluences, and less structural alteration in adjacent cornea. For 193 nm, structural alterations were minimal, confined to an area less than 0.3 micron wide, and did not increase with increasing fluence. These studies suggest that clinical strategies for excimer laser refractive surgery will employ the 193-nm wavelength, with fluence chosen depending on surgical strategy. Ablation exposures above 600 mJ/cm2 at 193 nm may give the most repeatable etch depth.