Lasers in Glaucoma: an Overview
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REVIEW
Lasers in Glaucoma: an Overview Bhawesh Chandra Saha . Rashmi Kumari Anita Ambasta . Sanjeev Kumar
. Bibhuti Prasanna Sinha .
Received: 6 August 2020 / Accepted: 6 November 2020 Ó Springer Nature B.V. 2020
Abstract Lasers have been in use as a treatment modality of glaucoma for more than last four decades. Each passing year has added newer dimensions to the existing laser technologies enhancing their safety and efficacy profile. This has become possible due to continuous research and innovations with proper understanding of the mechanism of action of different variety of lasers as treatment options. Each category of glaucoma has different underlying pathologies. Adequate knowledge and understanding of indications, limitations and hazards of these laser procedures are
B. C. Saha Department of Ophthalmology, AIIMS, Patna, India e-mail: [email protected] R. Kumari (&) Regional Institute of Ophthalmology , IGIMS, Patna, India e-mail: [email protected] B. P. Sinha Regional Institute of Ophthalmology , IGIMS, Patna, India e-mail: [email protected] A. Ambasta Regional Institute of Ophthalmology, IGIMS, Patna, India e-mail: [email protected] S. Kumar Department of Ophthalmology , SKMCH, Muzaffarpur, India e-mail: [email protected]
must before their application for improvising outcome. Recent years have witnessed a revolution this field. A thorough literature search was conducted in PubMed, Medline, the Cochrane Library Database, EMBASE, and Scopus and Google Scholar until May 2020 using the keywords, and all the articles pertaining to the relevant topics were included in this review. Purpose of this review is to summarize the important laser procedures currently in use for managing glaucoma along with updating the readers with recent advances in laser technologies, their extended applications and also analyzing possible future implications. Keywords Laser iridotomy Iridoplasty Laser trabeculoplasty Micropulse diode laser Pattern laser in glaucoma Cyclophotocoagulation
Introduction Townes and Schawlow, in 1954, invented ‘maser,’ that is, microwave amplification by stimulated emission of radiation. It was this idea which acted as the precursor of our present day ‘lasers,’ that is, light amplification by stimulated emission of radiation [1]. After two decades, in 1979, Wise and Witter demonstrated role of lasers in lowering intraocular pressure, although the precise mechanism of this pressure reduction remained unclear [2]. It was in 1983
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Anderson and Parrish discovered that selectively absorbed optical radiation could cause damage to pigmented structures [3]. Since then, lasers have regularly been used to treat glaucoma which is a leading cause of irreversible blindness world over [4]. Numerous laser designs and techniques have been innovated till date with aim of increasing efficacy and precision with greater safety profile minimizing collateral tissue damage. Their utility lies somewhere in between the medi
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