1. ADVANCES IN LASER & EYE SURYA

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

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

4. 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

5. Types of Lasers SURYA

6. Tissue Interactions SURYA

7. 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

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

10. Radiation Wavelengths 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) SURYA

11. Uses Diagnostic Therapeutic SURYA

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

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

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

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

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

17. LASIK Therapeutic Uses SURYA Suction RingMicrokeratomeFlap Removed

18. LASIK Therapeutic Uses SURYA LASIKFlap ReplacedPost - Op.

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

20. Therapeutic Uses B. Anterior Segment SURYA

21. What is Glaucoma ? Therapeutic Uses SURYA

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

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

24. Therapeutic Uses C. Posterior Segment SURYA

25. What is Diabetic Retinopathy ? Therapeutic Uses SURYA

26. What is Diabetic Retinopathy ? Therapeutic Uses SURYA

27. What is Diabetic Retinopathy ? Therapeutic Uses SURYA

28. What is Diabetic Retinopathy ? Therapeutic Uses SURYA

29. What is Diabetic Retinopathy ? Therapeutic Uses SURYA

30. What is Diabetic Retinopathy ? Therapeutic Uses SURYA

31. 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 6 - 12 months can detect early changes & prevent blindness

32. i. Diabetic Retinopathy Therapeutic Uses SURYA

33. i. Diabetic Retinopathy Therapeutic Uses Focal Grid Panretinal SURYA

34. ii. Retinal Haemorrhage Therapeutic Uses SURYA

35. iii. Retinal Breaks or Tears Therapeutic Uses SURYA

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

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

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

39. viii. Drainage of subretinal fluid / haem. Therapeutic Uses C. Posterior Segment SURYA

40. ix.Intraocular tumors (RB) Therapeutic Uses C. Posterior Segment SURYA

41. ix.Intraocular tumors (Choroidal Melanoma) Therapeutic Uses C. Posterior Segment SURYA

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

43. 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

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

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

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

47. What is ARMD ? SURYA Drusen

48. What is ARMD ? SURYA SRNVM

49. What is ARMD ? SURYA Vision in ARMD

50. What is PDT ?  Visudyne (Verteporfin)  “Smart Bomb” for wet ARMD  Selective Damage of SRNVM  Costly SURYA

51. What is PDT ? SURYA

52. What is PDT ? SURYA

53. What is PDT ? SURYA

54. What is PDT ? SURYA

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

56. What is PDT ? SURYA

57. 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

58. What is TTT ?  For wet ARMD  “Slow Cooking” of CNVM  Cheap SURYA

59. 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

60. THANK YOU SURYA