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Comparison of Holmium:YAG and Thulium Fiber Lasers on the Risk of Laser Fiber Fracture

Article dans une revue avec comité de lecture
Author
UZAN, Audrey
CHIRON, Paul
PANTHIER, Frédéric
HADDAD, Mattieu
BERTHE, Laurent
86289 Laboratoire Procédés et Ingénierie en Mécanique et Matériaux [PIMM]
DOIZI, Steeve
ccTRAXER, Olivier
413221 Sorbonne Université [SU]

URI
http://hdl.handle.net/10985/20620
DOI
10.3390/jcm10132960
Date
2021
Journal
Journal of Clinical Medicine

Abstract

Objectives: To compare the risk of laser fiber fracture between Ho:YAG laser and Thulium Fiber Laser (TFL) with different laser fiber diameters, laser settings, and fiber bending radii. METHODS: Lengths of 200, 272, and 365 mu m single use fibers were used with a 30 W Ho:YAG laser and a 50 W Super Pulsed TFL. Laser fibers of 150 mu m length were also tested with the TFL only. Five different increasingly smaller bend radii were tested: 1, 0.9, 0.75, 0.6, and 0.45 cm. A total of 13 different laser settings were tested for the Ho:YAG laser: six fragmentation settings with a short pulse duration, and seven dusting settings with a long pulse duration. A total of 33 different laser settings were tested for the TFL. Three laser settings were common two both lasers: 0.5 J x 12 Hz, 0.8 J x 8 Hz, 2 J x 3 Hz. The laser was activated for 5 min or until fiber fracture. Each measurement was performed ten times. Results: While fiber failures occurred with all fiber diameters with Ho:YAG laser, none were reported with TFL. Identified risk factors of fiber fracture with the Ho:YAG laser were short pulse and high energy for the 365 mu m fibers (p = 0.041), but not for the 200 and 272 mu m fibers (p = 1 and p = 0.43, respectively). High frequency was not a risk factor of fiber fracture. Fiber diameter also seemed to be a risk factor of fracture. The 200 mu m fibers broke more frequently than the 272 and 365 mu m ones (p = 0.039). There was a trend for a higher number of fractures with the 365 mu m fibers compared to the 272 mu m ones, these occurring at a larger bend radius, but this difference was not significant. Conclusion: TFL appears to be a safer laser regarding the risk of fiber fracture than Ho:YAG when used with fibers in a deflected position.

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