Laser applications in ophthalmology: overview

Ophthalmology Laser technology has revolutionized many medical fields. In ophthalmology, lasers are used to photocoagulate, cut, remove, shrink, and stretch ocular tissues. New types of lasers and novel applications continue to be developed. Laser is an acronym for light amplification by stimulated emission of radiation. A laser contains material that releases photons. This process is amplified so the emitted photons are in phase and produce monochromatic coherent high intensity polarized light. In 1961, one year after its invention, the laser was used for experimental photocoagulation in animals. In 1963 it was tried for treatment of human eyes. Due to the fact that the optical media in the eye are transmissible to light, the laser offers the unique possibility of measuring and manipulating within a very strict localization without opening the eye. The properties of laser light are increasingly exploited for diagnostics in ophthalmic disease. The introduction of the laser as a tool in ophthalmology has revolutionized ophthalmic treatment. Unfortunately, it has been pointed out in international peace meetings that the biological effect evoked by lasers can also be used for intentional destruction of the vision of enemy soldiers. To prevent such an abuse of lasers against eyes, a strong formal international anti-laser weapon movement has been initiated.
LASER is short for Light Amplified Stimulated Emission of Radiations. Types of Lasers used in Ophthalmology 1. 2. 3. 4. Argon Laser Diode Laser YAG Laser Excimer Laser

What do Lasers do?

Laser rays have energy. When they hit the target, they transmit that energy to the target. Heat is also given out. The effects in the eye are a combination of the Laser and heat energy. Some Lasers are used to create holes, e.g. YAG Laser Iridotomy in Glaucoma. The Excimer Laser has cutting power, used in LASIK. The Argon and Diode Lasers are used to create burns that treat Retinal tears and Diabetic Retinopathy (DMR).

Use of Laser in Ophthalmology

Lasers have been used widely in treatment of eye diseases. Such as, 1. Eyelid growths, including lid cancers 2. Trichiasis (Misdirected eye lashes) 3. Open up or block Lacrimal Punctum 4. Pterygium (Conjunctival degeneration) 5. To alter corneal curvature and correct refractive errors as in PRK, LASIK etc. 6. Glaucoma (Increased eye pressure) 7. To open opacified posterior capsule, about 6 months after cataract surgery 8. In closing Retinal tears in treatment and prevention of RD. 9. In Diabetic Retinopathy (DMR) 10. For treatment of tumors like Retinoblastoma.

The human eye is a favored target for laser surgery due to its accessibility via the optically transparent ocular tissue. Femtosecond lasers with confined tissue effects and minimized collateral tissue damage are primary candidates for high precision intraocular surgery. The advent of compact diode-pumped femtosecond lasers, coupled with computer controlled beam delivery devices, enabled the development of high precision femtosecond laser for ophthalmic surgery. In this article, anterior segment femtosecond laser applications currently in clinical practice and investigation are reviewed. Corneal procedures evolved first and remain dominant due to easy targeting referenced from a contact surface, such as applanation lenses placed on the eye. Adding a high precision imaging technique, such as optical coherence tomography (OCT), can enable accurate targeting of tissue beyond the cornea, such as the crystalline lens.

Periorbital skin rejuvenation. Treatment of vascular and pigmented eyelid lesions. Reshape the cornea in vision correction to improve nearsightedness, farsightedness and astigmatism. Refractive surgical procedures include LASIK. Remove/reduce certain superficial defects such as band keratopathy in the cornea. The procedure is called phototherapeutic keratoplasty. Place a window in a membrane called the posterior capsule if it opacifies following cataract surgery. The capsule holds the intraocular lens implant in place. The procedure is called YAG capsulotomy. Create a hole in the peripheral iris to prevent or treat an acute attack of narrow angle glaucoma. The procedure is called laser peripheral iridotomy. Place spots in the meshwork ("drain" of the eye) to lower eye pressure in open angle glaucoma. The procedure is called laser trabeculoplasty. Place spots in the ciliary body (produces fluid in the eye) to lower eye pressure in severe glaucomas. The procedure is called diode laser cyclophotocoagulation.

Place spots in the peripheral retina to treat proliferative diabetic retinal disease. The procedure is called panretinal photocoagulation. Place spots in the central retina for leakage in diabetic macular edema. The procedure is called focal retinal photocoagulation. Place spots in the peripheral retina for progressing retinopathy of prematurity. The procedure is called retinal photocoagulation. Treat certain types of wet age-related macular degeneration, a disease characterized by distorted central vision and damage to the central portion of the retina. One procedure is called focal retinal photocoagulation, and one procedure is called photodynamic therapy.

Ophthalmology, the medicine specializing in disease, surgery, and treatment of the eye, has been on the forefront of laser surgery with a growing number of people electing to skip the knife and choose the laser instead. Laser, which is an acronym for light amplified by stimulated emission of radiation, is a surgical device which uses electromagnetic radiation in the form of high energy light waves called photons. These photons, unlike other radiation heat sources, act in sync with each other, which give it its extreme power. Laser, then, plays a huge role in modern ophthalmology as it is a great tool for precise surgical procedures of the eye. Laser in ophthalmology is used to both alter human tissue (photocoagulate, cut, remove, shrink, and stretch the ocular tissue) and activate drugs when treating ocular diseases. Specifically, lasers can be used in ophthalmology for such diseases as: o Diabetic Retinopathy, a chronic disease based on sugar metabolism which can be severe enough to cause vision loss o Senile Macular Degeneration, a scaring in the macula of the eye due to age which can be severe enough to cause vision loss o Glaucoma Trabeculoplasty, a disease that effects the proper drainage function of eye fluids o Posterior Capsulotomy, a procedure done as a follow-up to cataract surgery in order to restore vision Lasers are also well known for use in ophthalmology surgeries to help patients eliminate the need for glasses and for cosmetic procedures to the eyelids. In ophthalmology, laser is used in the same way no matter what specific surgery is being performed. The patient is awake under a specialized microscope with an ophthalmology laser attached. In most cases, no anesthesia is given; however, sometimes a local anesthetic is used. The surgeon will use the laser by focusing a beam of light and then distribute several quick burst of the energy source to the located area. Ophthalmology laser surgery is usually very quick, often only lasting anywhere from five to twenty minutes, and is usually painless. After the procedure is performed, the patient is able to function normally, even drive if needed. Laser in ophthalmology usually is very safe and painless; though, like any surgery, the use of lasers can have some complications. For instance, one of the more common problems with laser surgery is tissue damage due to the high

energy source. Bleeding and vision loss, though very uncommon, are also complications that can occur from the use of lasers in ophthalmology surgery. In order to avoid such complications as much as possible, it is very important to research the licensing and training of the ophthalmologist you choose for any eye procedure. Article Source: http://EzineArticles.com/3018049