Hierarchical periodic micro/nano-structures on nitinol and their influence on oriented endothelialization and anti-thrombosis

The applications of hierarchical micro/nano-structures, which possess properties of two-scale roughness, have been studied in various fields. In this study, hierarchical periodic micro/nano-structures were fabricated on nitinol, an equiatomic Ni-Ti alloy, using a femtosecond laser for the surface modification of intravascular stents. By controlling the laser fluence, two types of surfaces were developed: periodic nano- and micro/nano-structures. Evaluation of water contact angles indicated that the nano-surface was hydrophilic and the micro/nano-surface was hydrophobic. Endothelial cells aligned along the nano-structures on both surfaces, whereas platelets failed to adhere to the micro/nano-surface. Decorrelation between the responses of the two cell types and the results of water contact angle analysis were a result of the pinning effect. This is the first study to show the applicability of hierarchical periodic micro/nano-structures for surface modification of nitinol.

Femtosecond laser cataract surgery

Femtosecond laser (FSL) cataract surgery is in its infancy but is rapidly gaining popularity due to the improved consistency and predictability for corneal incisions and anterior capsulorhexis. It enables subsequently less phacoemulsification energy and time to be employed, which has gains in terms of reduced corneal oedema. In addition, the FSL allows better circularity of the anterior capsulotomy, capsule overlap, intraocular lens (IOL) placement and centration of the IOL. These advantages have resulted in improved visual and refractive outcomes in the short term. Complication rates are low which reduce with surgeon experience. This review article focuses on the Alcon LenSx system.

Dependence of capillary forces on relative humidity and the surface properties of femtosecond laser micromachined titanium

Capillary forces were measured with colloidal atomic force microscopy at different levels of relative humidity on femtosecond laser micromachined titanium surfaces. After laser machining at different intensity levels, the titanium surfaces show a nanoscale ripple topology or microscopic bumpy structures. Different machining environments were chosen to influence the surface chemistry in addition to topology: while machining in pure oxygen and water resulted in surfaces consisting of TiO2, a composite surface of TiO2 and TiN was obtained after machining in pure nitrogen. All samples were subsequently exposed to pure oxygen, carbon dioxide or water, and showed different levels of wettability and capillary force. We have introduced the concept of humidity sensitivity as the relative increase of the capillary force with respect to the measured force at 0% humidity. We report that samples with a nanoscale ripple topology machined in pure oxygen exhibit the lowest level of capillary force and the lowest sensitivity towards humidity in the environment. Surfaces with low sensitivity towards changes of the relative humidity are good candidates for technical applications, where capillary forces have to be controlled. This study contributes to the development of such surfaces, to a better understanding of how capillary bridges are formed on rough surfaces and ultimately to the exploration of the relationship between surface wettability and capillary forces.

Effect of femtosecond laser beam angle on bond strength of zirconia-resin cement

Yttrium-stabilized tetragonal zirconia polycrystalline (Y-TZP) ceramic is widely used as an all-ceramic core material because of its enhanced mechanical and aesthetic properties. The bond strength of Y-TZP restorations affects long-term success; hence, surface treatment is required on ceramic boundaries. This study evaluated the effect of different laser beam angles on Y-TZP-resin cement shear bond strength (SBS). Forty plates of Y-TZP ceramics were randomly assigned to four groups (n = 10). A femtosecond amplifier laser pulse was applied on Y-TZP surface with different incidence angles (90°, 75°, 60°, 45°). The resin cement was adhered onto the zirconia surfaces. The SBS of each sample was measured using universal testing machine at crosshead speed of 1 mm/min. The SBS was analyzed through one-way analysis of variance (ANOVA)/Tukey tests. The results showed that the degree of laser beam angle affects the SBS of resin cement to Y-TZP. The laser beam was applied to a surface with a 45° angle which resulted in significantly higher SBS (18.2 ± 1.43 MPa) than other groups (at 90° angulation (10.79 ± 1.8 MPa), at 75° (13.48 ± 1.2 MPa) and at 60° (15.85 ± 0.81 MPa); p < 0.001). This study shows that decreasing of the angle between the ceramic surface and the laser beam increased the SBS between the resin cement and the ceramic material, as well as the orifice.

[SMILE: refractive lenticule extraction for myopic correction]

PURPOSE

It is currently possible to obtain refractive correction without using an excimer laser; the technique is called ReLEx(®) (Refractive Lenticule extraction) and uses the femtosecond laser VisuMax(®) (Carl Zeiss Meditec, Jena, Germany). We present initial clinical experience with small-incision (4mm) lenticule extraction (SMILE) for the treatment of moderate to high myopia via a retrospective study of 106 myopic and astigmatic eyes.

MATERIALS AND METHODS

This retrospective study of 106 eyes measures postoperative visual acuity to determine the safety, efficacy and predictability of the technique. For SMILE, an intrastromal lenticule is cut with the VisuMax(®) femtosecond laser; it is then dissected and detached from the anterior and posterior stromal planes and finally removed through a 4mm incision. This procedure does not require the creation of a flap. The study is based on 106 eyes of 54 patients who underwent the surgery for moderate to high myopia, with or without associated astigmatism. Patient selection was the same as for LASIK.

RESULTS

The average age of the patients was 33 ± 9 (20-54). The mean preoperative spherical equivalent was -6.22 ± 1.6 (-3; -9.75 D). The mean preoperative sphere was -5.88 D ± 1.52 (-3; -9.75 D) with a mean cylinder of -0.68 D ± 0.58 (0.00; -2.25). Postoperatively, 95% of patients had distance vision greater than or equal to 8/10. No loss of BCVA was noted. The mean postoperative spherical equivalent was -0.16 ± 0.35 D (-1.38; +0.88) with a mean sphere of 0.00 ± 0.34 D (-1,25; +1) and a mean cylinder of -0.31 ± 0.37 D (0; -1.5). One eye was converted to PRK because the incision site was covered by conjunctiva during the last 5 seconds of the laser phase.

CONCLUSION

SMILE is a predictable and safe technique for the surgical correction of moderate to high myopia.

Self‑propelled droplets on heated surfaces with angled self‑assembled micro/nanostructures

Directional and ratchet-like functionalized surfaces can induce liquid transport without the use of an external force. In this paper, we investigate the motion of liquid droplets near the Leidenfrost temperature on functionalized self-assembled asymmetric microstructured surfaces. The surfaces, which have angled microstructures, display unidirectional properties. The surfaces are fabricated on stainless steel through the use of a femtosecond laser-assisted process. Through this process, mound-like microstructures are formed through a combination of material ablation, fluid flow, and material redeposition. In order to achieve the asymmetry of the microstructures, the femtosecond laser is directed at an angle with respect to the sample surface. Two surfaces with microstructures angled at 45° and 10° with respect to the surface normal were fabricated. Droplet experiments were carried out with deionized water and a leveled hot plate to characterize the directional and self-propelling properties of the surfaces. It was found that the droplet motion direction is opposite of that for a surface with conventional ratchet microstructures reported in the literature. The new finding could not be explained by the widely accepted mechanism of asymmetric vapor flow. A new mechanism for a self-propelled droplet on asymmetric three-dimensional self-assembled microstructured surfaces is proposed.

Bilateral macular injury caused by a femtosecond laser

CASE REPORT

We describe the case of a 35-year-old man who arrived in the Emergency Department with bilateral macular injury caused by accidental exposure to an industrial femtosecond laser.

DISCUSSION

Workers operating industrial lasers must protect their eyes properly when handling these devices. Otherwise, retina damage may occur which usually is recoverable. However, sometimes this damage causes permanent visual loss.

Variations in fluorescence quantum yield of basic fuchsin with silver nanoparticles prepared by femtosecond laser ablation

Nano structured noble metals have very important applications in diverse fields such as photovoltaics, catalysis, electronic and magnetic devices, etc. In the present work, the application of dual beam thermal lens technique is employed for the determination of the absolute fluorescence quantum yield of the triaminotriphenylmethane dye, basic fuchsin in the presence of silver sol is studied. Silver sol is prepared by femtosecond laser ablation. It is observed that the presence of silver sol decreases the fluorescence quantum efficiency. The observed results are in line with the conclusion that the reduction in quantum yield in the quenching region is essentially due to the non-radiative relaxation of the absorbed energy. It is also observed that the presence of silver sol enhances the thermal lens signal which makes its detection easier at any concentration.

Evaluation of one- and two-photon activated photodynamic therapy with pyropheophorbide-a methyl ester in human cervical, lung and ovarian cancer cells

Two-photon activated photodynamic therapy (2-γ PDT) has the potential of treating deeper tumors and/or improving tumor targeting. Here, we evaluated the one- and two-photon activated PDT efficacy of pyropheophorbide-a methyl ester (MPPa), a second-generation photosensitizer derived from chlorophyll a. We show that MPPa, when activated by femtosecond (fs) laser pulses at 674 nm, has high one-photon (1-γ) PDT efficacy against cisplatin-sensitive human cervical (HeLa) and cisplatin-resistant human lung (A549) and ovarian (NIH:OVCAR-3) cancer cells. At a low light dose of 0.06 J cm(-2), the IC50 (the MPPa concentration required to kill 50% of the cells) was determined to be 5.3 ± 0.3, 3.4 ± 0.3 and 3.6 ± 0.4 μM for HeLa, A549 and NIH:OVCAR-3 cells, respectively. More significantly, we also show that MPPa can be effectively activated by an 800 nm, 120 fs laser through 2-γ excitation; at a light dose causing no measurable photocytotoxicity in the absence of photosensitizer, the corresponding IC50 values were measured to be 4.1 ± 0.3, 9.6 ± 1.0 and 1.6 ± 0.3 μM, respectively. These results indicate that MPPa is a potent photosensitizer for both 1- and 2-γ activated PDT with potential applications for difficult-to-treat tumors by conventional therapies.

Comparison of LASEK, mechanical microkeratome LASIK and Femtosecond LASIK in low and moderate myopia

PURPOSE

We conducted a prospective study to determine the best treatment option for patients with low-to-moderate spherical myopia or myopic astigmatism who are considered equally eligible for LASEK with mitomycin-C (MMC) and LASIK with either mechanical microkeratome or femtosecond laser flap creation.

METHODS

Forty-six adult patients (86 eyes) who underwent LASEK with MMC (16 patients, 31 eyes), and mechanical microkeratome LASIK (13 patients, 23 eyes) or Femtosecond LASIK (17 patients, 32 eyes) were assessed for clinical outcomes 1, 3 and 6 months post-operatively.

RESULTS

Six months after surgery, all eyes in all three groups were within 1 D of the intended refractive change. UCVA 20/20 or better was achieved in 96% of eyes undergoing LASEK with MMC 88% of eyes in the mechanical microkeratome LASIK and 72% of eyes in the Femtosecond LASIK group at 6 months. Mean spherical equivalent was -0.12 ± 0.22 D, -0.09 ± 0.28 D and -0.25 ± 0.28 D in the three groups, respectively (p = 0.077). Patients in the LASEK with MMC group had less high order aberrations at 3 and 6 months compared to the two LASIK groups. None of the three procedures were associated with early- or late-onset complications or loss of 2 or more lines after surgery.

CONCLUSIONS

After an initially slower visual improvement, LASEK with MMC, and to lesser extent, LASIK with mechanical microkeratome, produced better visual acuity and less corneal aberrations compared to Femtosecond LASIK at 3 and 6 months after surgery. These observations deserve further investigation in a randomized controlled trial.

Stromal bed quality and endothelial damage after femtosecond laser cuts into the deep corneal stroma

AIM

To evaluate the stromal bed quality and endothelial damage after femtosecond laser (FSL) cuts into the deep corneal stroma.

METHODS

Using a 150-kHz FSL, a lamellar cut was aimed at a depth of 100, 300, or 500 μm in porcine corneas. Stromal bed smoothness was graded from light microscopy and scanning electron microscopy images. Rabbit corneas were cut at remaining thicknesses of 70, 100 and 150 μm using the FSL. The effects of peeling off the corneal flap and the distance between laser spots (2 or 4 μm) were examined.

RESULTS

The ratio of damaged cells in the group with a remaining depth of 70 μm was significantly larger than that in the groups with a remaining depth of 150 μm. The ratio of damaged cells in the group with a 4-μm spot separation and the flap peeled off was significantly larger than that in the group with a 4-μm spot separation and the flap not peeled off.

CONCLUSIONS

Corneal endothelial damage is likely to increase when the remaining depth is less than 70 μm, and peeling off the flap damages corneal endothelial cells when the remaining depth is less than 100 μm.

Lower energy to make a corneal flap with a 60 kHz femtosecond laser reduces flap inflammation and corneal stromal cell death but weakens flap adhesion

Purpose

To compare corneal flaps created in rabbits with a 60 kHz femtosecond (FS) laser using different levels of raster energy and to measure early inflammation, corneal stromal cell death, and late postoperative adhesion strength.

Methods

Sixty rabbits were divided into three groups of 20 each. A flap 110 µm thick and 9.0 mm in diameter was made in one eye of each rabbit at raster energies of 0.7 µJ, 1.1 µJ, and 2.4 µJ. Histopathological evaluation for inflammation and apoptosis using terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining was performed at 4 and 24 hours after flap creation. The adhesion strength of the flaps was measured with a tension meter at 1 and 3 months.

Results

Twenty four hours after flap creation, the 2.4 µJ group had more inflammatory and CD11b-positive cells than the 0.7 and 1.1 µJ groups. The number of TUNEL-positive cells increased with raster energy at 4 and 24 hours. The grams of force (gf) needed to detach the flaps at 3 months was significantly higher in 2.4 µJ group (170 gf) than in 0.7 µJ group (97.5 gf) and 1.1 µJ group (100 gf, p = 0.03).

Conclusions

Using raster energy lower than 1.1 µJ to make a flap with a 60 kHz FS laser decreases inflammatory cell infiltration and corneal stromal cell death in the central cornea but may result in a weaker flap than using higher raster energy (2.4 µJ).

Factors influencing corneal flap thickness in laser in situ keratomileusis with a femtosecond laser

Purpose

To evaluate factors responsible for the variability between intended and achieved corneal-flap thickness during femtosecond laser-assisted laser in situ keratomileusis (LASIK).

Methods

A prospective, nonrandomized, case study was performed on 35 eyes of 18 consecutive patients who underwent LASIK surgery using the 60 kHz femtosecond laser microkeratome. Eyes were assigned to three different thickness groups, with 110-, 120-, or 130-µm cut depths. Anterior segment optical coherence tomography was used to assess the morphology of 35 LASIK flaps at postoperative one week postoperatively. The flap thickness was assessed at seven measuring points across each flap. Patient age, preoperative spherical equivalent, manual keratometry, preoperative central pachymetry, and regional variability of the cornea were evaluated to determine where they influenced the achieved corneal flap thickness.

Results

Cuttings of all flaps were easily performed without any intraoperative complications. Flap-thickness measurements had a mean of 115.21 ± 4.98 µm (intended thickness, 110 µm), 121.90 ± 5.79 µm (intended, 120 µm), and 134.38 ± 5.04 µm (intended, 130 µm), respectively. There was no significant difference between the 110-µm and 120-µm groups when compared with the 130-µm group (one-way analysis of variance test, p > 0.05). Patients' age, preoperative spherical equivalent, manual keratometry, and preoperative central pachymetry did not affect the achieved flap thickness (Pearson correlations test, p > 0.05). The reproducibility of flap thickness in the central 1.5-mm radius area was more accurate than that in the peripheral 3.0 to 4.0-mm radius area (paired samples t-test, p < 0.05).

Conclusions

Femtosecond laser-assisted LASIK is likely to reproduce a reliable thickness of the corneal flap, which is independent of corneal shape factors or refractive status. Future studies should focus on variations in corneal biomechanical factors, which may also play an important role in determining flap thickness.