Background:Diffuser fibers have been used for some time in the fields of laser-induced thermotherapy and photodynamic therapy. For their applicability the breaking strength, the thermostability and a homogeneous radiation profile are of great importance. Flexible applicators offer special benefits because they introduce a totally new range of application possibilities.Objective:The aim of the presented investigations was to develop a totally new flexible diffuser fiber generation which can be produced cheaper and without the use of any further materials. For this purpose it was proposed to induce scattering micro dots directly into silica fibers by generating a local change of the refractive index in the core of the optical fiber. The resulting diffuser was expected to create a homogeneous radiation profile containing at least 80% of the light coupled into the optical fiber, i.e. less than 20% prograde (forward) emission.Materials and methods:On the basis of former research results, scattering micro dots were induced linearly into the core of an optical silica fiber through a multiple photon process using a femtosecond laser. In addition to the macroscopic optical control by means of a microscope, the form of the radiation profile was examined as well as the non-scattered forward emission which depends on a variety of influencing factors. The processing was optimized according to the observations made. The thermostability of the developed prototypes was assessed by using a thermocamera, and the minimal bending radius was determined. Finally the prototypes were tested and validatedResults:An influence of the processing power, the number and radial position of the scattering micro dots as well as the therapeutic coupled-in wavelength onto the form of the radiation profile and the non-scattered forward emission was determined. Both the form of the radiation profile and the prograde emission were found to be independent of the therapeutic laser power coupled into the fiber. The developed prototype had a nearly homogeneous radiation profile, a forward emission of 12.8±2.1% in average, and a minimum bending radius of 31±6 mm.Conclusion:The non-scattered forward emission of the developed diffusers was within the objective of below 20% and the radiation profile was very nearly homogeneous. In order to improve the reproducibility of the production process, an improved fixation apparatus needs to be developed.