Those unfamiliar with this procedure assume that the laser beam is breaking a big floater into many small floaters. This is not the case.

Lightning Flash

What happens to the floater is similar to a lightning strike in nature. A lightening strike is an example of obliteration of matter under the influence of an intense electrical (optical spectrum) field. The mechanism for this obliteration is called “plasma formation” and “optical breakdown” which are terms used in describing laser physics. Optical breakdown requires (1) a very high frequency (changing from plus to minus) electrical field in the optical region of the electromagnetic spectrum that (2) is confined to a very small area. Upon firing a laser that can produce these conditions, the clear vitreous and floater become opaque (plasma formation) at a microscopic point, and they absorb the laser energy producing a micro lightening flash (optical breakdown). The laser performs this photo-conversion of the solid floater into a gas with a combination of photochemical, thermal, thermo-acoustical and electromagnetic optical field effects. Each time optical breakdown occurs, the surgeon sees the micro lightening flash on the surface of the floater and both the surgeon and the patient hear the acoustic component (a micro thunder snap). With most shots both the surgeon and the patient see the formation of a gas bubble.

The temperature at the center of the area of optical breakdown has been calculated to be several thousand degrees. At approximately 4000 degrees centigrade all solids are converted to gas. So there are more than adequate forces to change the form of matter from a solid to a liquid and to some extent to a gas.

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John Karickhoff, M.D. • 313 Park Avenue • Falls Church, VA 22046

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