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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

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ADVANCES INLASER& EYE

SURYA


Dr. Ajay DudaniDr. Vinod Goyel

SURYA

ZEN EYE CENTREKhar, Mumbai

SURYA EYETECHMulund, Mumbai

ISO 9001 : 2000 Certified


What is LASER ?

SURYA

L - Light

A - Amplification

by

S - Stimulated

E - Emission

of

R - Radiation


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

SURYA


Tissue Interactions

SURYA


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

SURYA

  • Transpupillary- Slit lamp

    - Laser Indirect Ophthalmoscopy

  • Trans scleral- Contact

    - Non contact

  • Endophotocoagulation


SURYA


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)


Uses

SURYA

Diagnostic

Therapeutic


Diagnostic Uses

SURYA

  • Laser Fluorescence Spectroscopy

  • Scanning Laser Ophthalmoscopy

  • Laser Interferometry

  • Fundus Fluorescein Angiography

Ffa PIC


Therapeutic Uses

SURYA

Widely Used -

  • Extra-ocular adnexae

  • Anterior Segment

  • Posterior Segment


Therapeutic Uses

SURYA

A. Extraocular Adnexae

i.Removal of lid masses

ii. Orbitotomies

iii.Blepharoplasty, Aesthetics (smoothen wrinkles)

iv.Capillary hemangioma, Portwine stain


Therapeutic Uses

SURYA

B. Anterior Segment

i. LASIK, PRK, PTK


Therapeutic Uses

SURYA

What is LASIK ?

  • Suitable for 2 to 9 Dioptres of Ref. Error

  • OPD Procedure

  • 5 minutes per eye


Therapeutic Uses

SURYA

LASIK

Suction Ring

Microkeratome

Flap Removed


Therapeutic Uses

SURYA

LASIK

LASIK

Flap Replaced

Post - Op.


Therapeutic Uses

SURYA

B. Anterior Segment

ii. Conjunctival / Corneal Growths, Neovascularization

iii. Cyclophotocoagulation


Therapeutic Uses

SURYA

B. Anterior Segment


Therapeutic Uses

SURYA

What is Glaucoma ?


Therapeutic Uses

SURYA

B. Anterior Segment

iv. Reopen failed filtering blebs

v. Iridoplasty, Gonioplasty

vi. Iris cyst, Pupilloplasty


Therapeutic Uses

B. Anterior Segment

SURYA

vii. Posterior Capsular Opacification


Therapeutic Uses

C. Posterior Segment

SURYA


Therapeutic Uses

SURYA

What is Diabetic Retinopathy ?


Therapeutic Uses

SURYA

What is Diabetic Retinopathy ?


Therapeutic Uses

SURYA

What is Diabetic Retinopathy ?


Therapeutic Uses

SURYA

What is Diabetic Retinopathy ?


Therapeutic Uses

SURYA

What is Diabetic Retinopathy ?


Therapeutic Uses

SURYA

What is Diabetic Retinopathy ?


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


Therapeutic Uses

SURYA

i. Diabetic Retinopathy


Therapeutic Uses

SURYA

i. Diabetic Retinopathy

Focal

Grid

Panretinal


Therapeutic Uses

SURYA

ii. Retinal Haemorrhage


Therapeutic Uses

SURYA

iii. Retinal Breaks or Tears


Therapeutic Uses

SURYA

C. Posterior Segment

iv. Subretinal neovascularisation

v. Central serous retinopathy


Therapeutic Uses

C. Posterior Segment

SURYA

vi. Vitreolysis in cystoid macular edema


Therapeutic Uses

SURYA

C. Posterior Segment

vii.Vitreous traction bands, to free encapsulated foreign bodies


Therapeutic Uses

SURYA

C. Posterior Segment

viii. Drainage of subretinal fluid / haem.


Therapeutic Uses

C. Posterior Segment

SURYA

ix.Intraocular tumors (RB)


Therapeutic Uses

C. Posterior Segment

SURYA

ix.Intraocular tumors (Choroidal Melanoma)


Therapeutic Uses

SURYA

C. Posterior Segment

x.Laser scleral buckling


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


SURYA

What is the Latest ?

PDT (Photo Dynamic Therapy)

TTT (Transpupillary Thermo Therapy)


SURYA

What is ARMD ?

Two types -

Dry ARMD

Wet ARMD


SURYA

What is ARMD ?

Wet ARMD -

Rare

More devastating

Drusen

SRNVM


SURYA

What is ARMD ?

Drusen


SURYA

What is ARMD ?

SRNVM


SURYA

What is ARMD ?

Vision in ARMD


SURYA

What is PDT ?

Visudyne (Verteporfin)

“Smart Bomb” for wet ARMD

Selective Damage

of SRNVM

Costly


SURYA

What is PDT ?


SURYA

What is PDT ?


SURYA

What is PDT ?


SURYA

What is PDT ?


Zeiss Visulas690s andVisulinkPDT adapter

Coherent OpalPhotoactivatorand LaserLinkadapter

SURYA

What is PDT ?


SURYA

What is PDT ?


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


SURYA

What is TTT ?

For wet ARMD

“Slow Cooking” of CNVM

Cheap


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…...


SURYA

THANK YOU


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