A Novel 3D High Resolution Imaging Method Using Correlative X-Ray and Electron Microscopy to Study Neodymium-Doped Yttrium Aluminum Garnet Laser-Induced Defects in Intraocular Lenses.

INTRODUCTION: Cataract extraction is the most frequently performed ophthalmological procedure worldwide. Posterior capsule opacification remains the most common consequence after cataract surgery and can lead to deterioration of the visual performance with cloudy, blurred vision and halo, glare effects. Neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy is the gold standard treatment and a very effective, safe and fast procedure in removing the cloudy posterior capsule. Damaging the intraocular lens (IOL) during the treatment may occur due to wrong focus of the laser beam. These YAG-pits may lead to a permanent impairment of the visual quality. METHODS: In an experimental study, we intentionally induced YAG pits in hydrophilic and hydrophobic acrylic IOLs using a photodisruption laser with 2.6 mJ. This experimental study established a novel 3D imaging method using correlative X-ray and scanning electron microscopy (SEM) to characterize these damages. By integrating the information obtained from both X-ray microscopy and SEM, a comprehensive picture of the materials structure and performance could be established. RESULTS: It could be revealed that although the exact same energies were used to all samples, the observed defects in the tested lenses showed severe differences in shape and depth. While YAG pits in hydrophilic samples range from 100 to 180 µm depth with a round shape tip, very sharp tipped defects up to 250 µm in depth were found in hydrophobic samples. In all samples, particles/fragments of the IOL material were found on the surface that were blasted out as a result of the laser shelling. CONCLUSION: Defects in hydrophilic and hydrophobic acrylic materials differ. Material particles can detach from the IOL and were found on the surface of the samples. The results of the laboratory study illustrate the importance of a precise and careful approach to Nd:YAG capsulotomy in order to avoid permanent damage to the IOL. The use of an appropriate contact glass and posterior offset setting to increase safety should be carried out routinely.

Approaching Standardization: Mechanical Material Testing of Macroscopic Two-Photon Polymerized Specimens.

Two-photon polymerization (2PP) is becoming increasingly established as additive manufacturing technology for microfabrication due to its high-resolution and the feasibility of generating complex parts. Until now, the high resolution of 2PP is also its bottleneck, as it limited throughput and therefore restricted the application to the production of microparts. Thus, mechanical properties of 2PP materials can only be characterized using nonstandardized specialized microtesting methods. Due to recent advances in 2PP technology, it is now possible to produce parts in the size of several millimeters to even centimeters, finally permitting the fabrication of macrosized testing specimens. Besides suitable hardware systems, 2PP materials exhibiting favorable mechanical properties that allow printing of up-scaled parts are strongly demanded. In this work, the up-scalability of three different photopolymers is investigated using a high-throughput 2PP system and low numerical aperture optics. Testing specimens in the cm-range are produced and tested with common or even standardized material testing methods available in conventionally equipped polymer testing labs. Examples of the characterization of mechanical, thermo-mechanical, and fracture properties of 2PP processed materials are shown. Additionally, aspects such as postprocessing and aging are investigated. This lays a foundation for future expansion of the 2PP technology to broader industrial application.