LASER AND ITS APPLICATION IN MEDICINE.

Dr. Mohammed Fathi.

 Table of contents

Introduction ___________________________________________ 2

Laser-matter interaction _________________________________ 3

Clinical applications of lasers ______________________________ 4

Lithotripsy _____________________________________________ 5

Ophthalmology _________________________________________ 6

Oncology ______________________________________________ 7

Lasers in Neurosurgery ___________________________________ 9

laser dentistry _________________________________________ 10

References ____________________________________________ 12

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 Introduction
Medical lasers for different clinical strategies including dermatology and plastic medical
procedure, wound healings, nerve incitement, dentistry, malignancy treatment, and
ophthalmic surgeries are investigated. The key standards behind the innovations are
additionally introduced. The laser spectra of UV (200-400) um, noticeable (400-700) nm,
close IR (700-2900) nm, and mid-IR (3-5) um having different infiltration profundities
characterize intrusive and noninvasive techniques. Diode lasers have been generally
utilized in numerous surgeries including delicate tissue cutting, coagulation and malignancy
warm treatment. Different photosensitizers are introduced in coordinating the laser
assimilation frequencies. At long last, the standards and utilizations of photo thermal
treatment (PTT) and photodynamic treatment (PDT) are talked about in incredible
subtleties.

Right now, the key standards behind the medical laser applications will be introduced,
including the laser spectra of UV (200-400) um, noticeable (400-700) nm, close IR (700-
2900) nm, and mid-IR (3-5) um having different infiltration profundities which characterize
obtrusive and noninvasive techniques. Diode lasers for different surgeries including
delicate tissue cutting, coagulation and malignant growth warm treatment will be explored.
Different photosensitizers are introduced in coordinating the laser retention frequencies. At
last, the standards and uses of photothermal treatment (PTT) and photodynamic treatment
(PDT) will be talked about in extraordinary subtleties.

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 Laser-matter interaction
The impact that a laser has on an example of tissue is subject to the two properties of the
tissue just as the laser. The tissue properties incorporate its structure, water content, warm
conductivity, heat limit, thickness, and its capacity to ingest, dissipate, or mirror the
discharged vitality. The properties of the laser that assume a job are its capacity, thickness,
vitality substance, and frequency .

The main biological focuses on that are managed retain light in an unexpected way, and
their ideal ingestion spectra rely upon the frequency of the occurrence photon vitality. For
the noticeable light and some close infrared lasers, the main objective chromophores (any
substance that retains light) are hemoglobin and melanin, though for CO2 lasers, the main
chromophore is water. So as to accomplish particular photothermolysis (utilizing vitality at
high pinnacle powers and short heartbeat widths to decimate the proposed target alone)
without harming the encompassing tissue, the objective tissue must contain chromophores
that assimilate a particular laser frequency, and these chromophores ought not be found in
the encompassing tissue

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 Clinical applications of lasers
As insignificantly obtrusive methods are constantly being searched out for the treatment of
various pathologic procedures, the utilization of lasers has gotten progressively mainstream
in present day medication. Notwithstanding their commonsense handiness in the working
room, lasers have a wide scope of utilizations in ophthalmology, lithotripsy, the
determination and treatment of different malignancies, just as dermatologic and restorative
techniques.

Lasers have been utilized for different medical strategies including dermatology, plastic
medical procedure, wound healings, nerve incitement, dentistry, ophthalmology and
numerous other restorative and surgeries. Joining the nanoparticles and photosensitizers,
diode lasers have been additionally utilized for malignant growth determination and
treatment. Chosen medical laser frameworks (gadgets) which have been marketed or
utilized for look into are shown below for both photodynamic and photothermal and
applications, where beat lasers are in vitality per beat (mJ) and CW lasers are in power (W).

Laser type Wavelength (pulse width) Energy/power

Ti:sapphire 780 nm (p.s. and f.s.) (0.01 – 0.1) mJ

Nd:YAG/YLF 1064/1053 nm (n.s. and p.s.) (1.0 – 20) mJ

Ho:YAG 2100 nm (µs) (10 – 20) mJ

Er:YAG 2940 nm (µs) (10 – 20) mJ

Fiber-laser 0.5-3.2 microns (n.s-p.s) (0.05 – 0.1) mJ

UV excimer laser 193, 308 nm (ns) (5 -20) mJ

Solid state laser 213, 266, 532 nm (ns) (2-10) mJ

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 Lithotripsy
Laser lithotripsy has been a broadly acknowledged method for the fracture of urinary and
biliary stones for as long as barely any decades. Lasers can achieve lithotripsy by having a
photoacoustical/photomechanical impact (laser-initiated shockwave lithotripsy) or a
transcendently photo thermal impact. Of the lasers generally utilized in lithotripsy, the 1-
µsec beat color laser is the most well-known shockwave laser and has been broadly
examined. This device depends on the excitation of coumarin color to deliver the
monochromatic light that parts the calculi. At 504 nm, a green light that is assimilated to a
great extent by the yellow-shaded urinary calculi is delivered, which permits it to be
securely utilized without making a lot of harm surrounding tissues. As the stone assimilates
the vitality from the laser, the energized particles that are discharged structure a rapidly
extending and throbbing cloud around the stone, making a stun wave that at that point
breaks the math into pieces
Since this laser is ineffectual against the nonabsorbent vapid calculi, for example, those
made out of cystine, photosensitizers (color) have effectively been utilized as water system
liquids and sponges to start the procedure of discontinuity. The Q-exchanged Nd:YAG
laser likewise achieves lithotripsy by this system, yet it produces bigger greatness of
shockwaves

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 Ophthalmology
Ophthalmology is the study of medical conditions relating to the eye. Ophthalmologists are
doctors who specialize in the medical and surgical treatment of this organ.

1. For retina operation, unmistakable laser can be utilized. Noticeable light is transparent
to the cornea and crystalline focal point, and can be centered with eye's focal point
around the retina. The most well-known obvious laser is the green argon laser.
• Treatment of glaucoma: Argon laser is centered remotely around iris to make entry
point, making waste gaps for overabundance watery humors to discharge pressure,
• Retina tear: photocoagulation consume to fix retina tears because of injury to the head.
• Diabetic retinopathy: insufficient blood supply to the retina because of diabetes.
Littlephotocoagulation consumes by green argon laser to fix the retina because of
vessels

2. For cornea and focal point, UV light discharged by the excimer laser is emphatically
consumed by water and proteins, so their vitality can be consumed by transparent
cornea and focal point, allowing laser medical procedure on these areas.
• Cataracts: a smooth structure in the focal point of the eye. Photograph vaporization by
utilizing UV laser to expel the opaque areas.
• Correction of nearsightedness: over centering of the focal point. Excimer laser
expulsion of surface of cornea to cause it to smooth.

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 Oncology
Lasers are as of now being securely utilized for the treatment of malignant growths
emerging in different organ frameworks. In neurosurgery for instance, laser interstitial
warm treatment (LITT) is a favored treatment alternative for patients who are not perfect
careful up-and-comers. Since first experience with neurosurgery, lasers have gotten
progressively protected to utilize and have been effectively applied for the treatment of
unrespectable gliomas just as hard and hemorrhagic tumors, for example, meningioma’s,
tumors of the profound skull base, or tumors somewhere down in the ventricles

Laser medical procedure is a sort of medical procedure that utilizes exceptional light pillars
rather than devices, for example, surgical blades. There are a few sorts of lasers. Each is
utilized to do certain things during medical procedure. Laser light can be conveyed either
persistently or discontinuously. It tends to be utilized with fiber optics to treat zones of the
body that are regularly difficult to reach. These are a portion of the lasers utilized for
malignancy treatment:
• Carbon dioxide (CO2) lasers.CO2 lasers can expel an extremely slim layer of tissue
from the outside of the skin without expelling further layers. The CO2 laser might be
utilized to expel skin malignant growths and some precancerous cells.
• Neodymium:yttrium-aluminum-garnet (Nd:YAG)lasers. Nd:YAG lasers can get further
into tissue. They can make blood cluster rapidly. The laser light can be brought through
optical strands to arrive at inward pieces of the body. For instance, the Nd:YAG laser
can be utilized to treat throat malignant growth.
• Laser-incited interstitial thermotherapy (LITT). LITT utilizes lasers to warm certain
pieces of the body. The lasers are coordinated to regions inside body tissues that are

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 almost a tumor. The warmth from the laser raises the temperature of the tumor. That
therapists, harms, or executes the malignant growth cells.
• Argon lasers.Argon lasers go just through external layers of tissue, for example, skin.
Argon lasers can be utilized to treat skin issues or in eye medical procedure.
Photodynamic treatment (PDT) utilizes argon laser light to actuate synthetic
concoctions in the malignant growth cells.
Advantages and limitations
• Lasers are more exact than standard careful instruments (surgical tools), so they harm
typical tissues. Subsequently, patients normally have less agony, dying, expanding, and
scarring. With laser treatment, tasks are normally shorter. Indeed, laser treatment should
regularly be possible on an outpatient premise. It requires some investment for patients
to mend after laser medical procedure, and they are less inclined to get diseases.
• Laser treatment additionally has a few restrictions. Specialists probably specific
preparing before they can do laser treatment, and severe security precautionary
measures must be followed. Laser treatment is costly and requires massive hardware.
Furthermore, the impacts of laser treatment may not keep going long, so specialists may
need to rehash the treatment for a patient to get the full advantage.
• Lasers additionally might be utilized to assuage certain side effects of malignant
growth, for example, draining or check. For instance, lasers can be utilized to recoil or
pulverize a tumor that is hindering a patient's trachea (windpipe) or throat. Lasers
additionally can be utilized to evacuate colon polyps or tumors that are hindering the
colon or stomach.

Photodynamic therapy (PDT)is another sort of cancer treatment that utilizes lasers. In PDT,
a specific medication, called a photosensitizer or photosensitizing specialist, is infused into
a patient and consumed by cells everywhere throughout the patient's body. Following a few
days, this specialist is found generally in malignant growth cells. Laser light is then used to
actuate the operator and demolish malignant growth cells. Since the photosensitizer makes
the skin and eyes delicate to light a short time later, patients are encouraged to stay away
from direct daylight and brilliant indoor light during that time.

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 Lasers in Neurosurgery
Neurosurgery manages maladies of the central nervous system (CNS), for example the
brain and the spine. Medical procedure of brain tumors is exceptionally troublesome, since
amazingly confined operations are fundamental because of the entangled structure and
delicacy of the brain. In addition, the tumor itself is frequently not effectively open, and
significant indispensable focuses are arranged adjacent to it. Thusly, it isn't astonishing that
a lot of research reserves is right now being spent right now, since any sort of brain tumor –
even kindhearted tumors – are incredibly dangerous. This is on the grounds that space
inside the skull is extremely restricted. Thus, development of new tissue builds the weight
inside the brain which prompts mechanical harm of different neurons

Regardless of their focal points, laser use is as yet not across the board in neurosurgery.
One explanation is the proceeded with absence of full oversight over real‐time laser
collaborations with neural tissue. A more prominent acknowledgment and utilization of
lasers by neurosurgeons will rely on mechanized power over characterized explicit
parameters for laser applications dependent on the sort of tissue, the ideal impact on tissue,
and application to the clinical circumstance without loss of accuracy and a great deal of
cost. This will require the mix of more up to date lasers, PCs, mechanical autonomy,
stereotaxic, and ideas of insignificantly obtrusive medical procedure into the standard
administration of neurosurgical issues.

The chief favorable circumstances of lasers in neurosurgery are clear. Lasers can cut,
disintegrate, and coagulate tissue without mechanical contact. This is of extraordinary
importance when managing extremely delicate tissues. Synchronous coagulation of veins
disposes of perilous hemorrhages which are very hazardous while happening inside the
brain. Besides, the zone of operation is cleaned as lasing happens, in this manner
diminishing the likelihood of potential diseases.

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 laser dentistry
Laser dentistry is the utilization of lasers to treat various distinctive dental conditions. It
turned out to be economically utilized in clinical dental practice for techniques including
tooth tissue in 1989.

Laser dentistry possibly offers an increasingly agreeable treatment alternative for various
dental techniques including hard or delicate tissue contrasted with drills and other non-laser
instruments.

LASER means "light enhancement by the invigorated emanation of radiation." The

instrument makes light vitality in an extremely limited and centered bar. This laser light
creates a response when it hits tissue, permitting it to evacuate or shape the tissue.

Laser dentistry is used in a variety of procedures, including:

• treating hypersensitivity
• treating tooth decay
• treating gum disease
• whitening teeth

How are laser treatments performed?

the two main sorts of strategies utilized for laser dentistry are hard tissue and delicate tissue
systems. Hard tissue alludes to the teeth, and delicate tissue alludes to the gums.
Regular hard tissue strategies include:
• Cavity detection. Lasers can recognize pits ahead of schedule by discovering proof of
tooth rot.
• Tooth arrangements and dental fillings. Neighborhood sedation and conventional drills
are frequently not required with laser medications. Lasers can eliminate microscopic
organisms in a cavity, which can help in the long haul soundness of a tooth.

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• Treating tooth sensitivity. Teeth that have sensitivity to hot and cold can be treated with
dental lasers that seal tubules on the tooth's root.

Regular delicate tissue systems include:

• Treating a "sticky grin." Lasers are utilized to reshape gum tissue related with "sticky
grin," in which the gums' length covers a significant part of the tooth.
• Crown extending. This methodology reshapes both gum tissue and bone for more
beneficial tooth structure, which assists with setting rebuilding efforts on the teeth.
• Treating tongue frenulum connection. Those with a thick or tight frenulum (the overlap
of skin under the forward portion of tongue that grapples to the mouth floor) may profit
by a laser frenectomy. This treatment helps kids whose limited frenulum makes them be
tongue-tied, experience issues breastfeeding, or have a discourse hindrance.
• Evacuating delicate tissue folds. Lasers can expel delicate tissue folds from sick fitting
false teeth without torment or sutures

Disadvantages of laser dentistry

• Lasers can't be utilized on teeth that as of now have particular sorts of filling, for
example, metal amalgam.
• Hard lasers can in some cases harm tooth mash.
• Some laser methods despite everything require sedation.
• Drills are still in some cases expected to finish fillings, including forming, modifying
the nibble, and cleaning the filling.
• Certain strategies isn't possible with laser treatment, contingent upon the previous
encompassing tissue or segments including the tooth or gums.
• There is a danger of gum injury.

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