Initial in vivo results of a hybrid retinal photocoagulation system

Evolution of Concepts and Technologies in Ophthalmic Laser Therapy

Ophthalmology was the first medical specialty to adopt lasers right after their invention more than 50 years ago, and they gradually revolutionized ocular imaging, diagnostics, therapy, and surgery. Challenging precision, safety, and selectivity requirements for ocular therapeutic and surgical procedures keep advancing the laser technologies, which in turn continue enabling novel applications for the preservation and restoration of sight. Modern lasers can provide single-cell-layer selectivity in therapy, submicrometer precision in three-dimensional image-guided surgery, and nondamaging retinal therapy under optoacoustic temperature control. This article reviews the evolution of laser technologies; progress in understanding of the laser-tissue interactions; and concepts, misconceptions, and accidental discoveries that led to modern therapeutic and surgical applications of lasers in ophthalmology. It begins with a brief historical overview, followed by a description of the laser-tissue interactions and corresponding ophthalmic applications.

Navigated Laser Therapy for Diabetic Macular Oedema

Navigated laser therapy introduces computerised assistance systems to retinal laser photocoagulation treatment. Some of the main benefits the Navilas system offers over conventional laser include high precision and safety and provides additional advantages in terms of standardisation of planning, execution, documentation, quality assurance and better overall treatment comfort for the patient. Navigated laser therapy is being used with good success in the treatment of diabetic macular oedema (DMO), retinal vein occlusions (RVO) and fastpattern navigated panretinal photocoagulation in proliferative diabetic retinopathy (PDR). In centre-involving DMO, a combination of anti-vascular endothelial growth factor (VEGF) and macular laser may provide advantages over anti-VEGF monotherapy. In terms of navigated laser therapy, recent study data from our clinic and other institutions indicate that combined initial anti-VEGF and navigated macular laser therapy allows treatment success to be achieved and maintained with a significantly reduced number of interventions.

Design and development of a computer-assisted retinal laser surgery system

Since the mid-1980s, the development of a therapeutic, computer-assisted laser photocoagulation system to treat retinal disorders has progressed under the guidance of Dr. Welch, the Marion E. Forsman Centennial Professor of Engineering, Department of Biomedical Engineering, the University of Texas at Austin. This paper reviews the development of the system, related research in eye movement and laser-tissue interaction, and system implementation and testing. While subsets of these topics have been reported in prior publications, this paper brings the entire evolutionary design of the system together. We also discuss other recent "spinoff" uses of the system technology that have not been reported elsewhere and describe the impact of the latest technical advances on the overall system design.