A Comparative Study Of Efficiency On CO₂ Laser Ablation Versus Electric Drill Grinding In Bone Removal Surgery

Traditional tools commonly used for bone osteotomy,such as the electric drill,chainsaw and bone chisel,still have some limitations in their application.Through continuous development,laser technology has become an important clinical treatment tool in modern medicine,allowing for contactless surgery,reduced intraoperative bleeding and mechanical vibration damage,and free geometric cutting compared to traditional tools.Recent studies have shown that lasers can effectively penetrate bone tissue.This study will utilize its penetrating ability to remove orbital bone tissue.Objective:A laser-suction confocal device was conceived and constructed utilizing the ability of laser ablation of bone tissue in order to explore the efficiency of the pulsed CO₂ laser in bone removal and post-operative bone healing.As a theoretical foundation for the practical use of laser in ophthalmic surgery,with electric drill therapy serving as a control.Methods:（1）A laser-suction confocal device was designed and constructed.（2）Four different power settings were used,and a CO₂ laser was applied as the light source to ablate rabbit orbital bone in vitro.The area of ablated bone was observed and measured under different power settings to determine the appropriate power level.（3）We built a rabbit orbital bone ablation model,used the electric drill as a control group.The effectiveness of CO₂ laser on bone and postoperative inflammatory response were assessed by HE staining,immunohistochemical staining,western blot,and enzyme-linked immunosorbent assay.Results:The ablation power of the CO₂ laser system in this experiment was tentatively calculated to be 1.31 W based on the thickness of the thermal damage layer and with different power levels.HE staining and scanning electron microscopy demonstrated that the pulsed CO₂ laser effectively ablated bone tissue,yielding similar results as the electric drill.However,pulsed CO₂ laser ablation induced higher postoperative expression of IL-6 and TNF-α,a prolonged inflammatory response,and lower expression of factors related to bone regeneration.Conclusion:（1）The ablation power of the pulsed CO₂ laser system in this experiment was determined to be 1.31W.（2）Both pulsed CO₂ laser and electric drill can be effective in removing bone,and pulsed CO₂ laser ablation can be used to achieve results similar to those of electric drill grinding.（3）We preliminarily verified the delayed effect of the CO₂ laser on bone reconstruction.（4）Chronic inflammatory response may be one of the factors for delayed bone regeneration.（5）This study provides optical parameter evidence supporting the clinical use of CO₂ lasers in orbital surgery,which may potentially enable the application of laser ablation techniques for orbital surgery.