Femtosecond subsurface photodisruption in scattering human tissues using long infrared wavelengths

Approximately 5 million people worldwide are blind due to complications from glaucoma, and an estimated 105 million have the disease. Current surgical techniques often fail due to scarring that is associated with disruption of the ocular surface tissues using conventional surgical methods. Demonstrated in the transparent cornea, femtosecond lasers can create a highly precise incision beneath the surface of a tissue. Since sclera is highly scattering with one micron light, the same wavelength used in cornea cannot be focused to the small spot necessary for photodisruption far beneath the surface of sclera. We now demonstrate completely subsurface incisions in human sclera by selecting a laser wavelength that is focusable beneath the surface, namely 1700 nm. Similar techniques may be used in other translucent tissues such as skin. Subsurface femtosecond photodisruption may be a useful for in vivo surgical technique to perform a completely subsurface surgery.