ADVANCES IN LASER & EYE SURYA

Dr. Ajay Dudani Dr. Vinod Goyel SURYA EYETECH Mulund, Mumbai ISO 9001 : 2000 Certified SURYA ZEN EYE CENTRE Khar, Mumbai

What is LASER ? L - Light A - Amplification by S - Stimulated E - Emission of R - Radiation SURYA

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

Types of Lasers SURYA

Tissue Interactions SURYA

Modes of Operation Mode depends on Laser material & Mode of excitation of material Two modes- Continuous wave operation Conventional pulsed operation - Q switched - mode locked SURYA

Delivery Systems Transpupillary- Slit lamp - Laser Indirect Ophthalmoscopy Trans scleral- Contact - Non contact Endophotocoagulation SURYA

Radiation Wavelengths 193 nm - Excimer (Cornea) nm- Argon (Retina) nm- Ruby nm - Diode 1064 nm- Nd Yag (Capsule) 10,600 nm- Carbon dioxide (Skin) SURYA

Uses Diagnostic Therapeutic SURYA

Diagnostic Uses Laser Fluorescence Spectroscopy Scanning Laser Ophthalmoscopy Laser Interferometry Fundus Fluorescein Angiography Ffa PIC SURYA

Therapeutic Uses Widely Used - Extra-ocular adnexae Anterior Segment Posterior Segment SURYA

i.Removal of lid masses ii. Orbitotomies iii.Blepharoplasty, Aesthetics (smoothen wrinkles) iv.Capillary hemangioma, Portwine stain Therapeutic Uses A. Extraocular Adnexae SURYA

B. Anterior Segment i. LASIK, PRK, PTK Therapeutic Uses SURYA

What is LASIK ? Therapeutic Uses SURYA  Suitable for 2 to 9 Dioptres of Ref. Error  OPD Procedure  5 minutes per eye

LASIK Therapeutic Uses SURYA Suction RingMicrokeratomeFlap Removed

LASIK Therapeutic Uses SURYA LASIKFlap ReplacedPost - Op.

B. Anterior Segment Therapeutic Uses ii. Conjunctival / Corneal Growths, Neovascularization iii. Cyclophotocoagulation SURYA

Therapeutic Uses B. Anterior Segment SURYA

What is Glaucoma ? Therapeutic Uses SURYA

iv. Reopen failed filtering blebs v. Iridoplasty, Gonioplasty vi. Iris cyst, Pupilloplasty Therapeutic Uses B. Anterior Segment SURYA

vii. Posterior Capsular Opacification Therapeutic Uses B. Anterior Segment SURYA

Therapeutic Uses C. Posterior Segment 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 ? Therapeutic Uses SURYA  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 months can detect early changes & prevent blindness

i. Diabetic Retinopathy Therapeutic Uses SURYA

i. Diabetic Retinopathy Therapeutic Uses Focal Grid Panretinal SURYA

ii. Retinal Haemorrhage Therapeutic Uses SURYA

iii. Retinal Breaks or Tears Therapeutic Uses SURYA

iv. Subretinal neovascularisation v. Central serous retinopathy Therapeutic Uses C. Posterior Segment SURYA

vi. Vitreolysis in cystoid macular edema Therapeutic Uses C. Posterior Segment SURYA

vii.Vitreous traction bands, to free encapsulated foreign bodies Therapeutic Uses C. Posterior Segment SURYA

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 C. Posterior Segment SURYA

x.Laser scleral buckling Therapeutic Uses C. Posterior Segment SURYA

i.Neovascular stimulation ii.Aseptic phototherapy for pre-op preparation iii.Laser asepsis for diagnosed infectious corneal ulcers iv.Endonasal DCR Therapeutic Uses D. Miscellaneous Uses SURYA

What is the Latest ? PDT (Photo Dynamic Therapy) TTT (Transpupillary Thermo Therapy) SURYA

What is ARMD ? SURYA Two types -  Dry ARMD  Wet ARMD

What is ARMD ? SURYA Wet ARMD -  Rare  More devastating  Drusen  SRNVM

What is ARMD ? SURYA Drusen

What is ARMD ? SURYA SRNVM

What is ARMD ? SURYA Vision in ARMD

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 ? SURYA

What is PDT ? SURYA Zeiss Visulas 690s and Visulink PDT adapter Coherent Opal Photoactivator and LaserLink adapter

What is PDT ? SURYA

What is PDT ? SURYA  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 ?  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

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