Mechanical damage of the retina is unlikely during excimer-or Er:YAG-laser ablation. The existence of a pressure focus may result in mechanical damages of the posterior lens or anterior vitreous at large ablation diameters. During Er:YAG laser ablation, shock waves could not be detected with our measurements. Theoretical estimations yield values of less than 700 mbar at a fluence of 1.2 J/cm2. The pressure load of the endothelium is independent of diameter but dependent on fluence.
In order to realize optimal shrinkage during thermokeratoplasty temperatures of 65-85 degrees C should be achieved in the coagulated tissue. Higher temperatures cause also a shrinkage effect but also a destruction of tissue.
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