Laser Surgery | Use of Lasers in the Eye

Lasers are commonly used to treat various eye diseases.  In almost every area of the eye, some type of laser surgery may be used to treat disease.

Here’s a short review of the various ways lasers are used in ophthalmology.

Laser Vision Correction

Perhaps the most “famous” use of laser is with laser vision correction.  PRK and LASIK are commonly advertised to correct refractive errors and reduce the need for contact lenses or glasses.

The excimer laser and the femtosecond laser are both used to reshape the cornea.   The curvature of the cornea strongly influences the refraction of the eye.

Laser vision correction can be used to treat nearsightedness, farsightedness, corneal scars and astigmatism.

Laser Cataract Surgery

The femtosecond laser can now be used to perform certain key aspects of routine cataract surgery.  Using the accuracy and predictability of the laser, laser cataract surgery may be more precise and lead to quicker healing compared to traditional cataract surgery.

The corneal incision, opening of the lens capsule and removal of the cataract may be performed with the accuracy of the laser.  In select patients, astigmatism may be treated as well.  The advantages of laser cataract surgery are somewhat "blurry."

After Cataract

A common occurrence after any cataract surgery is where the lens capsule, the clear tissue which holds the intraocular lens, becomes cloudy and causes blurry vision.  This “after cataract” can be treated by using a Nd:YAG laser to clear the lens capsule.

Glaucoma

Depending upon the type of glaucoma, different lasers may be used.

Open angle glaucoma can be treated with Argon Laser Trabeculoplasty (ALT), Selective Laser Trabeculoplasty (SLT) or Minipulse Laser Trabeculoplasty (MLT).  In all cases, the trabecular meshwork, the tissue which regulates drainage of internal fluid from the eye, is treated with laser to reduce the eye pressure.  Use of laser for open angle glaucoma is usually performed when eye drops are no longer effective. The laser increases absorption of aqueous humor and reduces the eye pressure.

Laser can be used to treat the ciliary body - the tissue of the eye which manufactures the aqueous humor.  This may be effective in reducing eye pressure by limiting production of fluid.

Narrow angle glaucoma is treated by creating an iridectomy.  An iridectomy creates a small hole in the iris which is created with the Nd:YAG laser.

Retina and Vitreous

The argon laser, diode laser and minipulse laser are used to treat patients with diabetic retinopathy, swelling from various retinal vascular disorders and others.  Tears in the retina are usually treated with the argon or diode laser.

Nd:YAG vitreolysis is performed for certain opacities within the vitreous.