Respirable particles in the excimer laser plume

Purpose: To determine whether respirable-size particles are present in the excimer laser plume following ablation of the corneal stroma. Setting: Outpatient laser vision correction facility. Methods: In this experimental study, an excimer laser was used to ablate 2 eye-bank corneas. Material from the plume was collected with filter paper that was coupled to a smoke evacuator. The filter paper was examined and photographed with an electron microscope. The particle size was measured with a computer program using digitized images of the photographs. As a control, room air was sampled using a smoke evacuator connected to a holder containing filter paper prior to the tissue ablation. Results: Ninety-eight particles were measured. The mean diameter was 0.22 μm ± 0.056 (SD). No particles were seen on the control filter paper. Conclusions: The plume created during excimer laser ablation of the cornea contained respirable-size particles. It is not known whether inhalation of these particles poses a significant health hazard. However, we recommend that a mask be worn by the surgeon and technical personnel assisting in excimer laser surgery. The plume should also be evacuated.