Technical advances, including new types of lasers and intraocular lenses, continue to dominate ophthalmic surgery. Controversy permeates the therapy for malignant melanoma of the choroid as well as surgery for near-sightedness and other refractive errors.
Two forms of lasers have become firmly established in ophthalmic practice—photocoagulators and photodisruptors. Photocoagulators, such as argon and krypton lasers, employ light energy that is absorbed by pigmented tissues of the eye, where it is converted to heat, causing microcauterizations. Photodisruptors, such as the neodymiumyttrium-aluminum-garnet (Nd-YAG) laser, function nonthermally by exploding unwanted tissue, even colorless tissue, in a controlled way. Microdissections of intraocular structures are thus feasible by aiming the laser beam through the cornea, and surgical instruments are not actually inserted inside the eyeball.
The argon laser, which emits a blue-green light, has been clearly established to be beneficial in moderately advanced forms of diabetic retinopathy (those with bleeding or neovascular proliferations).1 Positive
Goldberg MF, Sugar J. Ophthalmology. JAMA. 1985;254(16):2301–2303. doi:10.1001/jama.1985.03360160133034
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