Director - Department of Neurosurgery Ballad Health

Michaela Leitner

Ophthalmic lasers have not only enhanced the capabilities of ophthalmologists and eye specialists but also augmented the experience of eye patients.

 Ophthalmic lasers are revolutionizing the landscape of eye treatment, introducing robust and innovative capabilities into the sector. It has not only changed the approach of ophthalmologists and eye specialists but also enhanced the experience of patients. Eye clinics are beginning to incorporate laser technology into their offerings.

The interaction between the laser and the tissue comprises sequence, transmission, absorption, degradation, and tissue reaction. The ocular absorption depends on the wavelength of the laser and the kind of pigment present in the target tissue, namely melanin. The lasers utilized in ophthalmology are classified based on their uses.

Argon green, which is easily absorbed by hemoglobin, is commonly used to treat vascular conditions, whereas krypton red and diode infrared laser are used for peripheral retinal photocoagulation. Diode and neodymium YAG lasers produce invisible infrared wavelengths which can pass through the cornea and the sclera, and are used for the treatment of intraocular structures. Lasers are used to cause photocoagulation, photodisruption, and photoablation in the target tissue.

Below are the three Current Uses of Lasers in Ophthalmology:

Retinal Imaging

Ophthalmologists and researchers are incorporating adaptive optics to laser technology enhance the imaging of the retina. The development of quantitative phase imaging (QPI) algorithm will potentially pave the way for controlling adaptive-optics mirrors in ophthalmoscopes, leading to faster iterative calculation and better lateral resolution. The availability of efficient computers and the development of laser diodes have facilitated seamless, three-dimensional imaging of the retina. The digitized retinal imaging has bolstered the capabilities of clinicians in identifying severe retinopathy.

Ocular Diagnosis

The rapid innovation in computer processing and laser technology has augmented the study of naturally occurring retinal fluorescence, facilitating quicker detection of glaucoma, macular degeneration, and similar conditions which could potentially lead to blindness if left untreated. Autofluorescence is generated from lipofuscin, a pigment composed of minute granules caused due to cellular aging.

The abnormal buildup of the pigment in the retinal ganglion cells and retinal pigment epithelium is related to macular degeneration, which affects the portion of the retina responsible for central vision. The image of the retina is generated by raster-scanning a narrow beam of light across the retina using confocal scanning laser ophthalmoscope (SLO). The technique not only enables the users to probe the tissue but also enhances the resolution.

Lasers can potentially allow clinicians to identify the onset of Alzheimer’s diseases by facilitating the detection apoptosis. The amyloid-beta found in the brains of Alzheimer’s patients is also deposited on the retina and leads to apoptosis. Retinal ganglion cells are a lot easier to image when compared to depths of the human brain, and can facilitate better diagnosis outcomes.

Eye Surgery

Laser technology has significantly enhanced the capabilities of ophthalmologists, enabling them to save patients from blindness, causing conditions such as glaucoma, macular degeneration, and diabetic retinopathy. One of the most prevalent eye surgery approaches leveraged for the correction of vision in people with nearsighted, farsighted, astigmatism conditions is the laser in-situ keratomileusis (LASIK).

It is often conducted as an alternative to glasses and contact lenses. In this process, a cutting laser is used to precisely alter the shape of the cornea to enhance vision. The reshaping of the cornea offers the required bending needed for the correction of vision conditions caused by the incorrect bending of light.

Laser-assisted cataract surgery offers greater precision when compared to traditional cataract surgery. It leverages a camera or ultrasound imaging device to map the surface of the eye and gather information regarding the lens. The information is sent to the computer, which uses the data to program the laser according to the location, size, and depth of incisions. The surgeon utilizes laser tools to make incisions in the cornea, before using an ultrasound probe to break the lens.