Caesar Luo, MD, focuses his blog on retina topics from practice management to treatment techniques. 

BLOG: Common indications treated with laser

Lasers have become an essential tool in the modern ophthalmology practice. They are well known for precision and safety, and patients have come to expect and trust the use of a laser in their eye. The continuous development of research-backed applications, delivery modalities and platforms is making lasers more indispensable than ever in our practices.

A versatile, necessary tool

A highly versatile tool, laser treatment capabilities have extended to include a wide range of applications. Not surprisingly, diabetes-related pathology encompasses a large percentage of the procedures performed with a laser as well as the repair of retinal tears and retinal detachment and tumor treatment.

The 577 nm yellow and 532 nm green wavelength lasers provide us with the ability to treat the widest range of indications including proliferative diabetic retinopathy, diabetic macular edema and retinal tear/detachment.

In addition, practices with access to an 810 nm diode laser have the capability to treat specialized indications that include disorders of vascular angiogenesis in which more bleeding is involved and require a deeper laser penetration depth. This includes pathologies such as retinopathy of prematurity, familial exudative vitreoretinopathy and vitreous hemorrhaging.

Delivering low-energy laser protocols, rather than traditional high-energy laser treatment, utilizing MicroPulse laser technology (Iridex) enables clinicians to create subtle, well-defined sublethal intra-RPE injury that is reversible by endogenous repair mechanisms and spares the retina and choroid from collateral heat damage. Studies have demonstrated its safety and efficacy in the treatment of retinal disorders and shows promise as an adjunct to anti-VEGF to reduce the injection burden in patients with DME. In addition, MicroPulse transscleral cyclophotocoagulation using the Cyclo G6 glaucoma laser (Iridex) has shown safety and efficacy to reduce IOP in patients with glaucoma.

Laser add-ons to extend therapeutic capabilities

Pattern delivery technology can be a game changer when it comes to office efficiency and patient comfort, and is advantageous for delivering high-density laser spots required for effective MicroPulse laser therapy for the treatment of retinal pathologies.

Wide-angle viewing lenses are bringing laser into the periphery, easing the treatment of retinal tear and detachment and peripheral lesions. The majority of surgeons have been trained on laser indirect ophthalmoscopy, but new platforms such as the Navilas 577 (OD-OS) are making these peripheral treatments easier to administer.

Lasers have become a trusted instrument in the ophthalmologic profession. Today’s laser platforms offer safety and efficacy, and our patients and practices can benefit from the increasing range of therapeutic treatments we can provide.

Disclosure: Luo reports he is a consultant for AbbVie, Alimera, Allergan, Genentech, Iridex and Lumenis and receives research grands from Allergan and Lumenis.