Definition

• LASER is an acronym for

• L Light
• A Amplification (by)
• S Stimulated
• E Emission (of)
• R Radiation
• The laser is a source of coherent, directional,
monochromatic light that can be precisely focused
into a small spot. The laser is a very useful tool for a
wide variety of clinical diagnostic and therapeutic
procedures
Uses of LASER
• In Ophthalmology, the laser is used in a wide
spectrum of diseases, involving both anterior
segments (cornea, lens, iris) and posterior segments
(retina, choroidea, sclera) of the eye.
• In the most important eye diseases like diabetic
retinopathy, age-related macular degeneration,
glaucoma and cataract, lasers have become a very
important tool for diagnostics and therapy
• One of the outstanding features of lasers for the
application in ophthalmology is the possibility to
change the parameters like wavelength, intensity,
pulse duration, spot size etc. in an enormous range.
• In this way, laser-tissue interaction can be optimized;
it can be changed from diagnostics to therapy in the
same tissue
Applications of LASER

• Laser- tissue interactions

• Laser- therapeutic applications
• Laser- diagnostic applications
Laser- tissue interactions
Interactions of light with biological tissues depend on
it’s
• wavelength
• pulse duration
• irradiance (amount of power per unit area, W/cm2 )
Laser- tissue interactions
• Photocoagulation:
• Laser Light
• 
• Target Tissue 
• Generate Heat
• 
• Denatures Proteins
• ( Coagulation )
Rise in temperature of about 10 to 20 0C (to 50-60 0C) will cause
coagulation of tissue.
• Laser coagulation or laser photocoagulation surgery is used
to treat a number of eye diseases and has become widely
used in recent decades.
• During the procedure, a laser is used to finely cauterize
ocular blood vessels to attempt to bring about various
therapeutic benefits.
• The procedure is used mostly to close blood vessels in the
eye, in certain kinds of diabetic retinopathy; it is no longer
used in age-related macular degeneration in favor of
anti-VEGF drugs.
• The main aim of photocoagulation is to reduce retinal
oxygen demand, which is a regulator of angiogenesis.
• This treatment causes regression of retinal
neovascularization and reduces central macular
thickening, thus preventing vision loss from DR and
diabetic maculopathy.
Photodisruption:
• Photodisruption is a form of minimally invasive surgery used
in ophthalmology, utilizing infrared Nd:YAG lasers to form
plasma ("lightning bolt"), which then causes acoustic shock
waves ("thunderclap") which then in turn affects tissue.
• The tissue ruptures as a result of the vapor bubble produced
by the laser; the temperature required to produce this effect
is between 100 and 305 °C.
Vaporization
• With wery high pover of densitises, lasers will quickly
heat the tissues with temperature between 60—1000C
or above.
• Water within the tissues boils and evaporates.
• Photo- vaporization results in complete removal of the
tissue.
Photoablation:
• Breaks the chemical bonds that hold tissue together, essentially
vaporizing the tissue. E.g Photorefractive Keratectomy,
• Argon Fluoride (ArF)
• Excimer Laser
• Laser ablation or photoablation (also called laser blasting is
the process of removing material from a solid (or occasionally
liquid) surface by irradiating it with a laser beam.
• At low laser flux, the material is heated by the absorbed laser
energy and evaporates or sublimates.
PHOTORADIATION (PDT)
• Also called Photodynamic Therapy
• Photodynamic therapy uses a drug that is activated
by light, called a photosensitizer or photosensitizing
agent, to kill cancer cells. The light can come from a
laser or other source, such as LEDs.
Photodynamic therapy is also called PDT.
• Use: Treatment of ocular tumour and choroidal
neovascularisation
Ionization effect
• Highly energized focal laser beam is delivered on tissue over a period of
nanosecond or picoseconds and produce plasma in target tissue.
Switching Nd.Yag

Ionization (Plasma formation)
• 
Absorption of photon by plasma
• 
Increase in temperature and expansion of supersonic velocity
• 
Shock wave production → Tissue Disruption
Laser- therapeutic applications
1: ND:YAG laser (Neodymium-doped-yttrium- aluminium
garnet )
• Application:
• correct posterior capsular opacification
• peripheral iridotomy in patients with angle- closure
glaucoma
• laser trabeculoplasty in open angle glaucma
• freqency doubled ND:YAG lasers (wavelength 532nm) are
used for pan-retinal photocoagulation in patients with
diabetic retinopathy
2: Opacifcation of the lens (Cataract).
Corrects the posterior capsular opacification.
3: Intraocular fluid:
intraocular fluid: aqueos humor and vitreous humor
-- maintain intraocular pressure
4: Glaucoma
• Abnormal liquid drainage or liquid production result in
damage to the optic nerve and cause vision loss.
5: Laser trabeculoplasty:
The targets are the pigmented trabecular meshwork
cells in the angle of the eye.
excimer laser:
• An excimer laser is a powerful kind of laser
Application:
1: Refractive surgery
• Refractive eye surgery is an eye surgery used to improve the refractive
state of the eye and decrease or eliminate dependency on glasses or
contact lenses.
• This can include various methods of surgical remodeling of the cornea (
keratomileusis).
• The most common methods today use excimer lasers
to reshape the curvature of the cornea.
• Successful refractive eye surgery can reduce or cure common vision
disorders such as myopia, hyperopia and astigmatism, as well as
degenerative disorders like keratoconus
Refractive
Laser- Diagnostic application:
• Optical coherence tomography OCT
• anterior segmen
• posterior segment
• Optical coherence tomography angiography OCTA
• OCT is useful in diagnosing many eye conditions, including:
• macular hole
• macular pucker
• macular edema
• age-related macular degeneration
• glaucoma
• central serous retinopathy
• diabetic retinopathy
• vitreous traction
Thank you