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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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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.

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
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)
slide11
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
slide14

Therapeutic Uses

SURYA

A. Extraocular Adnexae

i. Removal of lid masses

ii. Orbitotomies

iii. Blepharoplasty, Aesthetics (smoothen wrinkles)

iv. Capillary hemangioma, Portwine stain

slide15

Therapeutic Uses

SURYA

B. Anterior Segment

i. LASIK, PRK, PTK

slide16

Therapeutic Uses

SURYA

What is LASIK ?

  • Suitable for 2 to 9 Dioptres of Ref. Error
  • OPD Procedure
  • 5 minutes per eye
slide17

Therapeutic Uses

SURYA

LASIK

Suction Ring

Microkeratome

Flap Removed

slide18

Therapeutic Uses

SURYA

LASIK

LASIK

Flap Replaced

Post - Op.

slide19

Therapeutic Uses

SURYA

B. Anterior Segment

ii. Conjunctival / Corneal Growths, Neovascularization

iii. Cyclophotocoagulation

slide20

Therapeutic Uses

SURYA

B. Anterior Segment

slide21

Therapeutic Uses

SURYA

What is Glaucoma ?

slide22

Therapeutic Uses

SURYA

B. Anterior Segment

iv. Reopen failed filtering blebs

v. Iridoplasty, Gonioplasty

vi. Iris cyst, Pupilloplasty

slide23

Therapeutic Uses

B. Anterior Segment

SURYA

vii. Posterior Capsular Opacification

slide24

Therapeutic Uses

C. Posterior Segment

SURYA

slide25

Therapeutic Uses

SURYA

What is Diabetic Retinopathy ?

slide26

Therapeutic Uses

SURYA

What is Diabetic Retinopathy ?

slide27

Therapeutic Uses

SURYA

What is Diabetic Retinopathy ?

slide28

Therapeutic Uses

SURYA

What is Diabetic Retinopathy ?

slide29

Therapeutic Uses

SURYA

What is Diabetic Retinopathy ?

slide30

Therapeutic Uses

SURYA

What is Diabetic Retinopathy ?

slide31

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
slide32

Therapeutic Uses

SURYA

i. Diabetic Retinopathy

slide33

Therapeutic Uses

SURYA

i. Diabetic Retinopathy

Focal

Grid

Panretinal

slide34

Therapeutic Uses

SURYA

ii. Retinal Haemorrhage

slide35

Therapeutic Uses

SURYA

iii. Retinal Breaks or Tears

slide36

Therapeutic Uses

SURYA

C. Posterior Segment

iv. Subretinal neovascularisation

v. Central serous retinopathy

slide37

Therapeutic Uses

C. Posterior Segment

SURYA

vi. Vitreolysis in cystoid macular edema

slide38

Therapeutic Uses

SURYA

C. Posterior Segment

vii. Vitreous traction bands, to free encapsulated foreign bodies

slide39

Therapeutic Uses

SURYA

C. Posterior Segment

viii. Drainage of subretinal fluid / haem.

slide40

Therapeutic Uses

C. Posterior Segment

SURYA

ix. Intraocular tumors (RB)

slide41

Therapeutic Uses

C. Posterior Segment

SURYA

ix. Intraocular tumors (Choroidal Melanoma)

slide42

Therapeutic Uses

SURYA

C. Posterior Segment

x. Laser scleral buckling

slide43

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 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 pdt5

Zeiss Visulas690s andVisulinkPDT adapter

Coherent OpalPhotoactivatorand LaserLinkadapter

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…...

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