Ultrahigh resolution spectral analysis based on a Brillouin fiber laser.

We report what we believe to be a novel experimental heterodyne technique for the spectral analysis of continuous optical wave sources. The achieved resolution is as low as the kilohertz level, with a dynamic range in excess of 90 dB. The technique is based on a heterodyne detection between the source under test (SUT) and a Brillouin fiber laser generated by this SUT. Contrary to standard self-heterodyne techniques only a few tens of meters of optical fiber is required without the need of any optical modulators. This spectrometer has been used to characterize a distributed-feedback laser diode and a Brillouin fiber laser.

Comparative study of wavelengths for laser lipolysis.

OBJECTIVE: This aim of this study was to evaluate the role of different wavelengths (920 nm, 980 nm, 1064 nm, 1320 nm, and 1440 nm) in laser lipolysis. BACKGROUND: Laser lipolysis is fast becoming a recognized technique for fat reduction. It has been demonstrated that (i) fat liquefaction is induced through a temperature elevation of the adipocyte cells, and (ii) fat volume reduction depends on total cumulative energy delivered at the treatment site. MATERIALS AND METHODS: The optical coefficients and the total attenuation for fat tissue were determined in the 400-1500 nm window. Numerical simulations were performed to estimate final fat reduction as a function of wavelength. RESULTS: The penetration depth of wavelengths between 900 and 1320 nm are largely similar, around 1.5 mm. The only minor difference is at 1440 nm, which is more absorbed by subcutaneous fat. The irreversibly damaged volume of tissue estimated by our numerical simulation is similar for wavelengths between 920 and 1320 nm. We obtain a final volume of 4 cm(3) with 3750 J delivered. CONCLUSION: With laser lipolysis, thermal elevation of a given volume can be obtained provided that the penetration depth remains in this nominal range. This explains why similar end results can be obtained using 920 nm, 980 nm, 1064 nm, and 1320 nm. Thermal build-up is the main factor behind adipocytolysis and skin contraction. Successful outcomes are dependent on the movement of the optical fiber inside the tissue and even and stable delivery of energy.

Mathematical modeling of laser lipolysis.

BACKGROUND AND OBJECTIVES: Liposuction continues to be one of the most popular procedures performed in cosmetic surgery. As the public's demand for body contouring continues, laser lipolysis has been proposed to improve results, minimize risk, optimize patient comfort, and reduce the recovery period. Mathematical modeling of laser lipolysis could provide a better understanding of the laser lipolysis process and could determine the optimal dosage as a function of fat volume to be removed. STUDY DESIGN/MATERIALS AND METHODS: An Optical-Thermal-Damage Model was formulated using finite-element modeling software (Femlab 3.1, Comsol Inc). The general model simulated light distribution using the diffusion approximation of the transport theory, temperature rise using the bioheat equation and laser-induced injury using the Arrhenius damage model. Biological tissue was represented by two homogenous regions (dermis and fat layer) with a nonlinear air-tissue boundary condition including free convection. Video recordings were used to gain a better understanding of the back and forth movement of the cannula during laser lipolysis in order to consider them in our mathematical model. Infrared video recordings were also performed in order to compare the actual surface temperatures to our calculations. The reduction in fat volume was determined as a function of the total applied energy and subsequently compared to clinical data reported in the literature. RESULTS: In patients, when using cooled tumescent anesthesia, 1064 nm Nd:YAG laser or 980 nm diode laser: (6 W, back and forth motion: 100 mm/s) give similar skin surface temperature (max: 41 degrees C). These measurements are in accordance with those obtained by mathematical modeling performed with a 1 mm cannula inserted inside the hypodermis layer at 0.8 cm below the surface. Similarly, the fat volume reduction observed in patients at 6-month follow up can be determined by mathematical modeling. This fat reduction depends on the applied energy, typically 5 cm3 for 3000 J. At last, skin retraction was observed in patients at 6-month follow up. This observation can be easily explained by mathematical modeling showing that the temperature increase inside the lower dermis is sufficient (48-50 degrees C) to induce skin tightening DISCUSSION AND CONCLUSION: Laser lipolysis can be described by a theoretical model. Fat volume reduction observed in patients is in accordance with model calculations. Due to heat diffusion, temperature elevation is also produced inside the lower reticular dermis. This interesting observation can explain remodeling of the collagenous tissue, with clinically evident skin tightening. In conclusion, while the heat generated by interstitial laser irradiation provides stimulate lipolysis of the fat cells, the collagen and elastin are also stimulated resulting in a tightening in the skin. This mathematical model should serve as a useful tool to simulate and better understand the mechanism of action of the laser lipolysis.

A new method for Intra Ocular Pressure in vivo measurement: first clinical trials.

Glaucoma is an ocular disease clinically manifested by an abnormal rise of the Intra Ocular Pressure (IOP) that causes lesions of the optic nerve and can lead to blindness. Ophthalmologists currently use applanation tonometers whose utilization induces multiple constraints. We propose an investigative method being at one and the same time atraumatic and ambulatory. This original device, taking profit of a physical relation between frequency of mechanical vibration of the ocular globe and IOP, involves vibrometry by laser interferometry and spectral analysis of a mechanical impulse using a temporal micro hammer. The laser energy delivered to the eye by the device was confirmed to be safe and in full agreement with the authorized security norms. After preliminary in vitro experiments performed using enucleated animal eyes, we made a clinical study on 25 volunteers to evaluate the innocuity and the reliability of this device and to quantify the reproducibility of measurements. All patients declared that discomfort is comparable with that felt during similar tests. Reliability is good and the intra individual reproducibility reveals a high value (R > or = 0.93). These works will be carried on to check the correlation between the variation of measured values (resonance frequency of the eye-ball) and the variation of reference (IOP) values.

Mathematical modeling of 980-nm and 1320-nm endovenous laser treatment.

BACKGROUND AND OBJECTIVES: Endovenous laser treatment (ELT) has been proposed as an alternative in the treatment of reflux of the great saphenous vein (GSV) and small saphenous vein (SSV). Numerous studies have since demonstrated that this technique is both safe and efficacious. ELT was presented initially using diode lasers of 810 nm, 940 nm, and 980 nm. Recently, a 1,320-nm Nd:YAG laser was introduced for ELT. This study aims to provide mathematical modeling of ELT in order to compare 980 nm and 1,320 nm laser-induced damage of saphenous veins. STUDY DESIGN/MATERIALS AND METHODS: The model is based on calculations describing light distribution using the diffusion approximation of the transport theory, the temperature rise using the bioheat equation, and the laser-induced injury using the Arrhenius damage model. The geometry to simulate ELT was based on a 2D model consisting of a cylindrically symmetric blood vessel including a vessel wall and surrounded by an infinite homogenous tissue. The mathematical model was implemented using the Macsyma-Pdease2D software (Macsyma, Inc., Arlington, MA). Calculations were performed so as to determine the damage induced in the intima tunica, the externa tunica and inside the peri-venous tissue for 3 mm and 5 mm vessels (considered after tumescent anesthesia) and different linear endovenous energy densities (LEED) usually reported in the literature. RESULTS: Calculations were performed for two different vein diameters: 3 mm and 5 mm and with LEED typically reported in the literature. For 980 nm, LEED: 50 to 160 J/cm (CW mode, 2 mm/second pullback speed, power: 10 W to 32 W) and for 1,320 nm, LEED: 50 to 80 J/cm (pulsed mode, pulse duration 1.2 milliseconds, peak power: 135 W, repetition rate 30 Hz to 50 Hz). DISCUSSION AND CONCLUSION: Numerical simulations are in agreement with LEED reported in clinical studies. Mathematical modeling shows clearly that 1,320 nm, with a better absorption by the vessel wall, requires less energy to achieve wall damage. In the 810-1,320-nm range, blood plays only a minor role. Consequently, the classification of these lasers into hemoglobin-specific laser wavelengths (810, 940, 980 nm) and water-specific laser wavelengths (1,320 nm) is inappropriate. In terms of closure rate, 980 nm and 1,320 nm can lead to similar results and, as reported by the literature, to similar side effects. This model should serve as a useful tool to simulate and better understand the mechanism of action of the ELT.

Mathematical modeling of endovenous laser treatment (ELT).

BACKGROUND AND OBJECTIVES: Endovenous laser treatment (ELT) has been recently proposed as an alternative in the treatment of reflux of the Great Saphenous Vein (GSV) and Small Saphenous Vein (SSV). Successful ELT depends on the selection of optimal parameters required to achieve an optimal vein damage while avoiding side effects. Mathematical modeling of ELT could provide a better understanding of the ELT process and could determine the optimal dosage as a function of vein diameter. STUDY DESIGN/MATERIALS AND METHODS: The model is based on calculations describing the light distribution using the diffusion approximation of the transport theory, the temperature rise using the bioheat equation and the laser-induced injury using the Arrhenius damage model. The geometry to simulate ELT was based on a 2D model consisting of a cylindrically symmetric blood vessel including a vessel wall and surrounded by an infinite homogenous tissue. The mathematical model was implemented using the Macsyma-Pdease2D software (Macsyma Inc., Arlington, MA, USA). Damage to the vein wall for CW and single shot energy was calculated for 3 and 5 mm vein diameters. In pulsed mode, the pullback distance (3, 5 and 7 mm) was considered. For CW mode simulation, the pullback speed (1, 2, 3 mm/s) was the variable. The total dose was expressed as joules per centimeter in order to perform comparison to results already reported in clinical studies. RESULTS: In pulsed mode, for a 3 mm vein diameter, irrespective of the pullback distance (2, 5 or 7 mm), a minimum fluence of 15 J/cm is required to obtain a permanent damage of the intima. For a 5 mm vein diameter, 50 J/cm (15W-2s) is required. In continuous mode, for a 3 mm and 5 mm vein diameter, respectively 65 J/cm and 100 J/cm are required to obtain a permanent damage of the vessel wall. Finally, the use of different wavelengths (810 nm or 980 nm) played only a minor influence on these results. DISCUSSION AND CONCLUSION: The parameters determined by mathematical modeling are in agreement with those used in clinical practice. They confirm that thermal damage of the inner vein wall (tunica intima) is required to achieve the tissue alterations necessary in order to lead the vein to permanent occlusion. However, in order to obtain a high rate of success without adverse events, the knowledge of the vein diameter after tumescent anesthesia is recommended in order to use the optimal energy. As clearly demonstrated by our calculations, both pulsed and continuous mode operations of the laser can be efficient. An interesting observation in our model is that less amount of energy is required in pulsed mode than in continuous mode. Damaging the vein sequentially along its entire length may lead to permanent occlusion. However, the pulsed mode requires a very precise positioning of the fiber after each pullback and the duration of the treatment is much longer. For these reasons, continuous irradiation seems to be preferred by most clinicians. This model should serve as a useful tool to simulate and better understand the mechanism of action of the ELT.