Ophthalmology is Reaching New Frontiers with Laser Technology

Ophthalmology is Reaching New Frontiers with Laser Technology

MedTech Outlook | Tuesday, August 27, 2019

The introduction of laser technology is enabling ophthalmologists and vision scientists to develop robust and innovative approaches to treat various eye conditions, ranging from retinal imaging to cataract surgery.

FREMONT, CA:  The incorporation of laser technology in the ophthalmic sector has empowered the treatment of various eye problems with minimal risk of infection. The new and innovative laser treatment techniques not only provide precise treatment for a wide range of eye problems but are also pain-free and cost-effective. Its applications include photo-thermal, photo-disruptive, and photo-ablative ophthalmic laser treatment.

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Lasers are becoming an integral part of ophthalmology, ranging from surgical treatments to diagnostics. Researchers are testing the potential of adaptive optics in enhancing laser-based microscopic techniques, which can allow practitioners to identify glaucoma and other destructive eye diseases in their earlier stages.

The well known German ophthalmologist Gerd Meyer-Schwickerath leveraged solar energy to induce scar formation and weld the retina to the underlying pigment epithelium. However, the introduction of lasers has taken ophthalmology to new landscapes, introducing minimally invasive, effective, safe treatments for the eye.

The argon laser is commercially available and is utilized as the standard treatment for retinal coagulation in the treatment of diseases such as diabetic retinopathy, choroidal neovascularisation, central vein occlusion, and ischaemic retinal vasculitis. It is also used in laser trabeculoplasty for the treatment of chronic open-angle glaucoma.

The high energy light is guided through an angular mirror in direct contact with the cornea, and focal coagulations are conducted in the trabecular meshwork of the anterior-chamber angle without opening the eye. By facilitating the outflow of aqueous humor, the intraocular pressure is reduced. The bleeding can be reduced during cutting by simultaneously inducing coagulation.

The holmium:YAG laser is used to facilitate the focal shrinkage of corneal tissue in the midperiphery of the cornea to induce a central slope. It increases the refractive power of the cornea, thus correcting hyperopia. Laser devices enable the coagulation of abnormal vascular tissue in the retina, the proliferation of which might lead to blindness.

Photorefractive keratectomy has led to the efficient and safe treatment of myopia. In this approach, laser ablation is focused on the stromal surface in steps less than 1mm to enable central corneal flattening, and the light is concentrated in the fovea of the axially enlarged eye.

Topography-based, wavefront-guided ablations are also being tested to correct irregular astigmatic changes of the cornea, and to create supernormal vision by eliminating natural optical aberrations. Laser ablation has found significant applications in phototherapeutic keratectomy to reduce superficial corneal opacifications in scars and dystrophies, to close the epithelium in noninfectious persisting corneal ulcers, and stop epithelial breaks in the recurrent-erosion syndrome.

Diabetic retinopathy has made new strides in ophthalmology. Photocoagulation is used to target the leaking blood vessels and damaged tissues in the retina. The laser is used to spot weld the damaged vessels and prevent leakage. It can also be used to terminate the target tissue in the periphery of the retina which is not essential for functional vision, thus enhancing the supply of blood to the central portion of the retina to maintain eyesight.

The peripheral retina is one of the factors leading to abnormal blood vessel formation. The termination of cells in the peripheral retina reduces the formation of abnormal retinal blood vessels. After laser treatment of the peripheral retina, the blood flow is restored to the central portion of the retina.

Although laser treatment for diabetic retinopathy cannot enhance vision, it is crucial to prevent significant deterioration of vision. The treatments depend on the condition of the eye and the extent of the damage. A clinically severe diabetic macular edema necessitates up to four different laser sessions to avert macular swelling.

The incorporation of lasers has led to enhances treatment of a wide range of conditions involving the anterior and posterior segments of the eye, including the most common causes of blindness such as diabetic retinopathy, macular degeneration, glaucoma, and cataract. As the operating knowledge and capabilities of laser technology increases, the pool of conditions that can be treated with ophthalmic lasers will also increase.

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