A limiting factor in the development of mid-infrared optics is the lack of abundant materials that are transparent, low cost, lightweight, and easy to machine. In this paper, we demonstrate a metasurface device that circumvents these limitations. A flat lens based on antenna reflectarrays was designed to achieve near diffraction-limited focusing with a high efficiency (experiment: 80%; simulation: 83%) at 45 o incidence angle at λ = 4.6 μm. This geometry considerably simplifies the experimental arrangement compared to the common geometry of normal incidence which requires beam splitters. Simulations show that the effect of comatic aberrations is small compared to parabolic mirrors. The use of single-step photolithography allows large scale fabrication.

A limiting factor in the development of mid-infrared optics is the lack of abundant materials that are transparent, low cost, lightweight, and easy to machine. In this paper, we demonstrate a metasurface device that circumvents these limitations. A flat lens based on antenna reflectarrays was designed to achieve near diffraction-limited focusing with a high efficiency (experiment: 80%; simulation: 83%) at 45 o incidence angle at λ = 4.6 μm. This geometry considerably simplifies the experimental arrangement compared to the common geometry of normal incidence which requires beam splitters. Simulations show that the effect of comatic aberrations is small compared to parabolic mirrors. The use of single-step photolithography allows large scale fabrication.

This study demonstrated the capability of soldering cuts in thick tissues, paving the way for new types of surgical applications.

Abstract:We present the development of a 5 mm, piezo-actuated, ultrafast laser scalpel for fast tissue microsurgery. Delivery of micro-Joules level energies to the tissue was made possible by a large, 31 μm, air-cored inhibited-coupling Kagome fiber. We overcome the fiber's low NA by using lenses made of high refractive index ZnS, which produced an optimal focusing condition with 0.23 NA objective. The optical design achieved a focused laser spot size of 4.5 μm diameter covering a 75 × 75 μm 2 scan area in a miniaturized setting. The probe could deliver the maximum available laser power, achieving an average fluence of 7.8 J/cm 2 on the tissue surface at 62% transmission efficiency. Such fluences could produce uninterrupted, 40 μm deep cuts at translational speeds of up to 5 mm/s along the tissue. We predicted that the best combination of speed and coverage exists at 8 mm/s for our conditions. The onset of nonlinear absorption in ZnS, however, limited the probe's energy delivery capabilities to 1.4 μJ for linear operation at 1.5 picosecond pulse-widths of our fiber laser. Alternatives like broadband CaF 2 crystals should mitigate such nonlinear limiting behavior. Improved opto-mechanical design and appropriate material selection should allow substantially higher fluence delivery and propel such Kagome fiber-based scalpels towards clinical translation.

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. Significance: The creation of subepithelial voids within scarred vocal folds via ultrafast laser ablation may help in localization of injectable biomaterials toward a clinically viable therapy for vocal fold scarring. Aim: We aim to prove that subepithelial voids can be created in a live animal model and that the ablation process does not engender additional scar formation. We demonstrate localization and long-term retention of an injectable biomaterial within subepithelial voids. Approach: A benchtop nonlinear microscope was used to create subepithelial voids within healthy and scarred cheek pouches of four Syrian hamsters. A model biomaterial, polyethylene glycol tagged with rhodamine dye, was then injected into these voids using a custom injection setup. Follow-up imaging studies at 1- and 2-week time points were performed using the same benchtop nonlinear microscope. Subsequent histology assessed void morphology and biomaterial retention. Results: Focused ultrashort pulses can be used to create large subepithelial voids in vivo . Our analysis suggests that the ablation process does not introduce any scar formation. Moreover, these studies indicate localization, and, more importantly, long-term retention of the model biomaterial injected into these voids. Both nonlinear microscopy and histological examination indicate the presence of biomaterial-filled voids in healthy and scarred cheek pouches 2 weeks postoperation. Conclusions: We successfully demonstrated subepithelial void formation, biomaterial injection, and biomaterial retention in a live animal model. This pilot study is an important step toward clinical acceptance of a new type of therapy for vocal fold scarring. Future long-term studies on large animals will utilize a miniaturized surgical probe to further assess the clinical viability of such a therapy.

Laser tissue soldering is a method of repairing incisions. It involves the application of a biological solder to the approximated edges of the incision and heating it with a laser beam. A pilot clinical study was carried out on 10 patients who underwent laparoscopic cholecystectomy. Of the four abdominal incisions in each patient, two were sutured and two were laser soldered. Cicatrization, esthetical appearance, degree of pain, and pruritus in the incisions were examined on postoperative days 1, 7, and 30. The soldered wounds were watertight and healed well, with no discharge from these wounds or infection. The total closure time was equal in both methods, but the net soldering time was much shorter than suturing. There was no difference between the two types of wound closure with respect to the pain and pruritus on a follow-up of one month. Esthetically, the soldered incisions were estimated as good as the sutured ones. The present study confirmed that temperature-controlled laser soldering of human skin incisions is clinically feasible, and the results obtained were at least equivalent to those of standard suturing.

Bonding of the UADT mucosa using a multi-wavelength, temperature-controlled laser soldering system can support significantly higher pressures then conventional CO(2) laser soldering and suture repair. The mean bonding pressure was 3.5-fold higher than the maximal swallowing pressure. Our findings provide a basis for implementation of new surgical tools for repair of esophageal perforations.