Lasers have found widespread applications in various medical fields, but their most extensive use is in ophthalmology. This is because the eye functions as an optical system, allowing light to reach different layers of the eyeball through its refractive media. The unique properties of lasers—such as their uniform wavelength and strong directionality—make them ideal for targeting specific tissues within the eye with precision. As a result, laser technology was first widely adopted in ophthalmology, eventually giving rise to a specialized branch of medicine known as laser ophthalmology.
Laser treatment of eye diseases has become a critical component of modern ophthalmic care. One of the key factors in selecting the appropriate laser for treatment is understanding how different wavelengths interact with ocular tissues. The absorption characteristics of various pigments in the eye determine which wavelengths are most effective for specific conditions. For instance, melanin absorbs shorter wavelengths more efficiently, while hemoglobin shows higher absorption for blue, green, and yellow light. Lutein, on the other hand, strongly absorbs blue light, making it important to avoid using blue light in the macular region to prevent damage to the retinal neuroepithelium.
Red and infrared light, though less absorbed by lutein, can penetrate deeper into the eye and are often used for conditions such as retinal hemorrhages or refractive errors. However, these wavelengths may not be as effective in areas without pigmentation and carry a risk of damaging deeper structures due to their high penetration. Ultraviolet light, with wavelengths below 295 nm, is mostly absorbed by the cornea and is primarily used in corneal surgeries.
The mechanism of laser treatment involves several physical and chemical processes. One of the most common is photoinduced heating, where laser energy is converted into heat, leading to effects such as coagulation, vaporization, or cutting of tissue. The extent of these effects depends on factors like laser power density, exposure time, and the absorption characteristics of the target tissue. In addition to thermal effects, lasers can also induce chemical reactions, such as photodecomposition or photodynamic therapy, which are used in treating conditions like retinoblastoma.
Another effect is the electromagnetic field generated by the laser. Although regular light has minimal impact, lasers with high energy concentration can create strong electric fields that influence biological tissues. Photoinduced pressure is another phenomenon where laser radiation causes mechanical stress, leading to vaporization, cutting, or even perforation of tissues. These mechanisms allow lasers to precisely treat a wide range of eye conditions, from cataracts to diabetic retinopathy, offering minimally invasive and highly targeted therapeutic options.
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