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An erbium (Er):YAG laser can remove trabecular meshwork (TM) by photothermal ablation with minimal contiguous thermal damage. A variable pulse width Er:YAG laser was used to investigate the effect of varying pulse width on ablation of human TM. Trabecular photothermal ablation was performed on tissue obtained from eye bank eyes at pulse widths of 50, 150, and 250 microseconds, with energy held constant at 4 mJ. At this energy, a single laser pulse was sufficient for full-thickness ablation of TM. Laser energy was delivered through a 200-microns diameter optical fiber held in apposition to the tissue sample, which was immersed in physiologic saline. High-speed photography of the resultant steam bubbles also was performed. Light microscopy and scanning electron microscopy of TM ablated at 50 microseconds revealed the greatest variability in size (0-140 microns) of the full-thickness ablated areas and demonstrated blast effects, tissue shredding and < or = 10 microns thermal damage. At 150 microseconds, the full-thickness ablated areas were more consistent size (115-120 microns), showed no blast effects and 10 to 20 microns thermal damage. At 250 microseconds, the largest ablations were found (180-220 microns) and showed no blast damage; however, a significant amount of thermal damage (< or = 50 microns) was evident. The steam bubbles produced by the laser energy were largest at 50 microseconds and did not begin to collapse until well over twice the original pulse interval. At 150 and 250 microseconds, the steam bubbles were successively smaller and dissipated at the end of the laser pulse.(ABSTRACT TRUNCATED AT 250 WORDS)

Background and Objectives: Treatment of vascular lesions is one of the main applications of cutaneous laser technology, while the other is laser hair removal. We present here a vascular laser pumped by a commercial hair removal laser. Study Design/Materials and Methods: A novel 524 nm vascular laser was designed using a 755 nm hair removal laser as a pumping source. This 524 nm vascular laser was used to treat facial redness and leg telangiectasias in 24 subjects. Four treatments were administered to the face at 4-6-week intervals and final photographs were taken 8 weeks following the final treatment, while two treatments were administered to lower-extremity spider veins at 2-month intervals with follow-up photographs 3 months following the final treatment. Blinded analysis of digital images was performed by two physicians not involved in the study. Results: Blinded evaluation of digital photographs revealed an average improvement score of 3.3 ± 1.7 (mean ± SEM) on a 0-10 scale for removing facial redness (p < 0.001), representing a 33% improvement. Leg veins improved an average of 51% corresponding to a score of 5.1 ± 2.0 (p < 0.001). Side effects were mild and limited to erythema, purpura, edema, and one instance of mild hyperpigmentation. Conclusions: This novel 524 nm laser is safe and effective for treating vascularity on the face and legs, and proves the ability to create a laser platform incorporating a hair removal laser which then can be used as a pumping source for the attached vascular laser module.