Illuminated Scalpels: How Lasers have Impacted the World of Medicine and Optical Surgery



January 17, 2013

By Eve Pearce

Lasers are leading the way today in the surgical field, making procedures using the beams quicker and safer than traditional surgeries. Indeed, lasers have impacted the world of medicine as they are regularly used in such medical and health specialties as cardiology, dermatology, gastroenterology, gynecology, neurosurgery, oncology, pulmonology, orthopedics, and ophthalmology

Therefore, about every system in the body can be treated with lasers, including the heart, skin, intestinal tract, reproductive system, nervous system, lungs bones, and eyes. In addition, lasers are also used in cosmetic procedures as well and are most often used for removing tattoos, excess body hair, wrinkles, or birthmarks. Indeed, lasers offer added safety and protection to anyone contemplating surgery.

Three basic types of lasers are used in surgical procedures, namely the YAG (yttrium aluminum garnet) laser; the Co2 or carbon dioxide laser, and the pulsed dye laser. Lasers possess different beams or colors, each of which, in turn, is applied to a specific procedure. Basically, lasers, when used in surgery, are employed to safely kill diseased tissue; destroy lesions or shrink tumors; cauterize or seal vessels in the circulatory system; improve the appearance or wrinkled skin; or to treat eye diseases, such as glaucoma.

Treatment of glaucoma
In the field of optics, lasers are used quite frequently, and are applied in procedures that treat the two main types of glaucoma, or open-angle glaucoma and angle-closure glaucoma. These diseases, which steal one’s sight, are caused by an elevation in the intraocular pressure (IOP), or the pressure within the eye.

Most glaucoma sufferers are affected by open-angle glaucoma. The disease, which develops gradually over time, does not exhibit any symptomatology. Therefore, it can only detected upon a vision exam. Also known as chronic glaucoma, the condition is caused by a clog in the drainage system in the eye or when the eye produces an overflow of aqueous fluid, either of which increases the IOP.

On the other hand, angle-closure glaucoma, also referred to as narrow-angle glaucoma, results when the drainage canal is blocked by the iris or the space between the iris and cornea narrow. Unlike open-angle glaucoma, which occurs slowly over time, angle-closure glaucoma develops rather rapidly and produces symptoms that are suddenly noticeable. These symptoms can include nausea which accompanies severe optical pain, blurred or sudden loss of sight, or excruciating headache or eye pain.

Individuals who are at an increased risk for glaucoma have a genetic predisposition toward the disease, are of Latino or African-American descent, or may suffer from diabetes or cardiovascular disease. The chances that glaucoma will develop also increase with age.

Surgical procedures
Actually, optical lasers were the first lasers used in surgical procedures and have been used for this purpose since 1960. Given the number of years lasers have been employed to correct the vision then, they have more than proven their worth in the optical field.

Laser surgery used to treat glaucoma directs the laser beam on the drainage system of the eye, also known as the trabecular meshwork. This beam causes an increase in fluid drainage, thereby reducing the IOP.

The most common glaucoma surgeries using a laser include Selective Laser Trabeculoplasty (SLTl) and Argon Laser Trabeculoplasty (ALT), both which are used to treat the most common form of glaucoma – primary open-angle glaucoma, or POAG. The laser used for SLT is a low-level beam and is applied to treat certain selective cells, thereby leaving those parts of the trabecular meshwork that are not treated undamaged. As a result, this procedure can be repeated, if necessary.

On the other hand, the laser used in ALT treats half of each of the fluid channels separately in order to increase drainage. This procedure has notably been shown to reduce IOP in three-fourths of the patients who are treated.

Micropulse Laser Trabeculoplasty or MLT is a new kind of laser procedure and is distinct in the fact it uses a diode laser to deliver quick microbursts of energy. MLT reduces IOP much in the same way as ALT and SLT.

Angle-closure glaucoma is typically treated with Laser Peripheral Iridotomy or LPI. The beam used in LPI creates a tiny hole in the eye’s iris, which, in turn, causes the iris to stop blocking the drainage canals in the eye.

All laser surgeries to treat glaucoma assist in reducing IOP. Some people, depending on the severity of the disease, may need to have the surgery repeated. While medication must continue to be used following treatment, the amount of medication taken is often reduced.

LASIK surgery
Besides glaucoma laser surgery, one of the best-known corrective eye surgeries using a laser is LASIK surgery. LASIK is an acronym Laser-Assisted In Situ Keratomileusis, and is helpful for correcting such vision difficulties as astigmatism, myopia (nearsightedness or shortsightedness); or hyperopia (farsightedness).

The laser reshapes the eye’s cornea, thereby adjusting the light rays so they focus correctly through the lens and onto the retina.

Laser surgery comes with many advantages as the heat that is created from the beam keeps the treatment site free of bacteria and therefore reduces the chance of infection. Because they involve less time, laser surgeries cost less than traditional surgical procedures. Recovery periods are quicker too as fewer side effects result from the surgery.

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