Advances in laser eye
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ADVANCES IN LASER & EYE. SURYA. Dr. Ajay Dudani Dr. Vinod Goyel. SURYA. ZEN EYE CENTRE Khar, Mumbai. SURYA EYETECH Mulund, Mumbai. ISO 9001 : 2000 Certified. What is LASER ?. SURYA. L - Light A - Amplification by S - Stimulated E - Emission of R - Radiation.

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Advances in laser eye

ADVANCES INLASER& EYE

SURYA


Dr ajay dudani dr vinod goyel

Dr. Ajay DudaniDr. Vinod Goyel

SURYA

ZEN EYE CENTREKhar, Mumbai

SURYA EYETECHMulund, Mumbai

ISO 9001 : 2000 Certified


What is laser

What is LASER ?

SURYA

L - Light

A - Amplification

by

S - Stimulated

E - Emission

of

R - Radiation


What is laser1

What is LASER ?

SURYA

Substances have the property to “lase” i.e.absorb energy in one form & emit a new form of light energy which is more useful.


Types of lasers

Types of Lasers

SURYA


Tissue interactions

Tissue Interactions

SURYA


Modes of operation

Modes of Operation

SURYA

Mode depends on

  • Laser material &

  • Mode of excitation of material

    Two modes-

  • Continuous wave operation

  • Conventional pulsed operation

    - Q switched

    - mode locked


Delivery systems

Delivery Systems

SURYA

  • Transpupillary- Slit lamp

    - Laser Indirect Ophthalmoscopy

  • Trans scleral- Contact

    - Non contact

  • Endophotocoagulation


Advances in laser eye

SURYA


Radiation wavelengths

Radiation Wavelengths

SURYA

  • 193 nm - Excimer (Cornea)

  • 488 - 514 nm- Argon (Retina)

  • 694.3 nm- Ruby

  • 780 - 840 nm - Diode

  • 1064 nm- Nd Yag (Capsule)

  • 10,600 nm- Carbon dioxide (Skin)


Advances in laser eye

Uses

SURYA

Diagnostic

Therapeutic


Diagnostic uses

Diagnostic Uses

SURYA

  • Laser Fluorescence Spectroscopy

  • Scanning Laser Ophthalmoscopy

  • Laser Interferometry

  • Fundus Fluorescein Angiography

Ffa PIC


Therapeutic uses

Therapeutic Uses

SURYA

Widely Used -

  • Extra-ocular adnexae

  • Anterior Segment

  • Posterior Segment


Advances in laser eye

Therapeutic Uses

SURYA

A. Extraocular Adnexae

i.Removal of lid masses

ii. Orbitotomies

iii.Blepharoplasty, Aesthetics (smoothen wrinkles)

iv.Capillary hemangioma, Portwine stain


Advances in laser eye

Therapeutic Uses

SURYA

B. Anterior Segment

i. LASIK, PRK, PTK


Advances in laser eye

Therapeutic Uses

SURYA

What is LASIK ?

  • Suitable for 2 to 9 Dioptres of Ref. Error

  • OPD Procedure

  • 5 minutes per eye


Advances in laser eye

Therapeutic Uses

SURYA

LASIK

Suction Ring

Microkeratome

Flap Removed


Advances in laser eye

Therapeutic Uses

SURYA

LASIK

LASIK

Flap Replaced

Post - Op.


Advances in laser eye

Therapeutic Uses

SURYA

B. Anterior Segment

ii. Conjunctival / Corneal Growths, Neovascularization

iii. Cyclophotocoagulation


Advances in laser eye

Therapeutic Uses

SURYA

B. Anterior Segment


Advances in laser eye

Therapeutic Uses

SURYA

What is Glaucoma ?


Advances in laser eye

Therapeutic Uses

SURYA

B. Anterior Segment

iv. Reopen failed filtering blebs

v. Iridoplasty, Gonioplasty

vi. Iris cyst, Pupilloplasty


Advances in laser eye

Therapeutic Uses

B. Anterior Segment

SURYA

vii. Posterior Capsular Opacification


Advances in laser eye

Therapeutic Uses

C. Posterior Segment

SURYA


Advances in laser eye

Therapeutic Uses

SURYA

What is Diabetic Retinopathy ?


Advances in laser eye

Therapeutic Uses

SURYA

What is Diabetic Retinopathy ?


Advances in laser eye

Therapeutic Uses

SURYA

What is Diabetic Retinopathy ?


Advances in laser eye

Therapeutic Uses

SURYA

What is Diabetic Retinopathy ?


Advances in laser eye

Therapeutic Uses

SURYA

What is Diabetic Retinopathy ?


Advances in laser eye

Therapeutic Uses

SURYA

What is Diabetic Retinopathy ?


Advances in laser eye

Therapeutic Uses

SURYA

What is Diabetic Retinopathy ?

  • Severity of DR runs parallel to the duration of DM

  • 50 % of Diabetics have DR after 10 years of DM

  • 90 % of Diabetics have DR after 20 years of DM

  • A regular checkup every 6 - 12 months can detect early changes & prevent blindness


Advances in laser eye

Therapeutic Uses

SURYA

i. Diabetic Retinopathy


Advances in laser eye

Therapeutic Uses

SURYA

i. Diabetic Retinopathy

Focal

Grid

Panretinal


Advances in laser eye

Therapeutic Uses

SURYA

ii. Retinal Haemorrhage


Advances in laser eye

Therapeutic Uses

SURYA

iii. Retinal Breaks or Tears


Advances in laser eye

Therapeutic Uses

SURYA

C. Posterior Segment

iv. Subretinal neovascularisation

v. Central serous retinopathy


Advances in laser eye

Therapeutic Uses

C. Posterior Segment

SURYA

vi. Vitreolysis in cystoid macular edema


Advances in laser eye

Therapeutic Uses

SURYA

C. Posterior Segment

vii.Vitreous traction bands, to free encapsulated foreign bodies


Advances in laser eye

Therapeutic Uses

SURYA

C. Posterior Segment

viii. Drainage of subretinal fluid / haem.


Advances in laser eye

Therapeutic Uses

C. Posterior Segment

SURYA

ix.Intraocular tumors (RB)


Advances in laser eye

Therapeutic Uses

C. Posterior Segment

SURYA

ix.Intraocular tumors (Choroidal Melanoma)


Advances in laser eye

Therapeutic Uses

SURYA

C. Posterior Segment

x.Laser scleral buckling


Advances in laser eye

Therapeutic Uses

SURYA

D. Miscellaneous Uses

i.Neovascular stimulation

ii.Aseptic phototherapy for pre-op preparation

iii.Laser asepsis for diagnosed infectious corneal ulcers

iv.Endonasal DCR


What is the latest

SURYA

What is the Latest ?

PDT (Photo Dynamic Therapy)

TTT (Transpupillary Thermo Therapy)


What is armd

SURYA

What is ARMD ?

Two types -

Dry ARMD

Wet ARMD


What is armd1

SURYA

What is ARMD ?

Wet ARMD -

Rare

More devastating

Drusen

SRNVM


What is armd2

SURYA

What is ARMD ?

Drusen


What is armd3

SURYA

What is ARMD ?

SRNVM


What is armd4

SURYA

What is ARMD ?

Vision in ARMD


What is pdt

SURYA

What is PDT ?

Visudyne (Verteporfin)

“Smart Bomb” for wet ARMD

Selective Damage

of SRNVM

Costly


What is pdt1

SURYA

What is PDT ?


What is pdt2

SURYA

What is PDT ?


What is pdt3

SURYA

What is PDT ?


What is pdt4

SURYA

What is PDT ?


What is pdt5

Zeiss Visulas690s andVisulinkPDT adapter

Coherent OpalPhotoactivatorand LaserLinkadapter

SURYA

What is PDT ?


What is pdt6

SURYA

What is PDT ?


What is pdt7

SURYA

What is PDT ?

Treatment is designed to reduce the risk of vision loss

Vision improves in few cases

Re-treatment is often required at 3-month intervals during the first 2 years


What is ttt

SURYA

What is TTT ?

For wet ARMD

“Slow Cooking” of CNVM

Cheap


Lasers can

SURYA

Lasers can….

Save a child’s eye as in Retinoblastoma

Change a personality as in LASIK

Cure a middle aged person with Glaucoma

Restore Vn. in a person with After-Cataract

Preserve & Retain Vn. in pts. with DR & ARMD

The possibilities are endless…...


Thank you

SURYA

THANK YOU


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