Name : Ooi Zhi Wen Matthew Group : S7 Topic : Laser Surgery Student ID : 0901G70254

History of Lasers

A laser is a device that emits light (electromagnetic radiation) through a process called stimulated emission. The name LASER is an acronym for Light Amplification by the Stimulated Emission of Radiation. In 1954, Charles Townes and Arthur Schawlow invented the maser (microwave amplification by stimulated emission of radiation), using ammonia gas and microwave radiation - the maser was invented before the (optical) laser. The technology is very close but does not use a visible light. Many different materials can be used as lasers. Some, like the ruby laser, emit short pulses of laser light. Others, like helium-neon gas lasers or liquid dye lasers emit a continuous beam of light. In 1960, Theodore Maiman invented the ruby laser considered to be the first successful optical or light laser.

The physics of a Laser

The gain medium of a laser is a material of controlled purity, size, concentration, and shape, which amplifies the beam by the process of stimulated emission. It can be of any state: gas, liquid, solid or plasma. The gain medium absorbs pump energy, which raises some electrons into higherenergy ("excited") quantum states. Particles can interact with light both by absorbing photons or by emitting photons. Emission can be spontaneous or stimulated. When the number of particles in one excited state exceeds the number of particles in some lower-energy state, population inversion is achieved and the amount of stimulated emission due to light that passes through is larger than the amount of absorption. Hence, the light is amplified. When an optical amplifier is placed inside a resonant optical cavity, we have a laser.

] Applications of Laser in Surgery

Laser Eye Surgery LASIK is the most recent advance in laser vision correction. LASIK is an acronym for Laser Assisted In-situ Keratomileusis. Compared to the original laser PRK, the surface of the cornea remains largely intact so that LASIK patients are more comfortable and see better more quickly. LASIK has been performed internationally for approximately 10 years. It was first performed in U.S. clinical trials in 1991. It is important to note that the major components of the procedure have a long history. Ophthalmologists have been reshaping the cornea for over 50 years, creating a protective layer of tissue for over 35 years, and using the excimer laser since the 1980s.

How the surgery is performed

After anesthetic eyedrops are put on the eye, a suction ring is centered over the cornea of the eye. This suction ring stabilizes the position of your eye and increases the pressure to a level that is needed for proper functioning of the microkeratome. The guide tracks on this suction ring are used to provide a precise path for the microkeratome.

The microkeratome is a very precise instrument that is the "keystone" in the LASIK procedure. This device is a mechanical shaver that contains a sharp blade that moves back and forth at high speed. This shaver is placed in the guide tracks of the suction ring and is advanced across the cornea using gears at a controlled speed. This process creates a partial flap in the cornea of uniform thickness. The flap is created with a portion of the cornea left uncut to provide a hinge.

After the suction ring and microkeratome have been removed, the corneal flap is folded back on the hinge exposing the middle portion of the cornea.

The excimer laser is then used to remove tissue and reshape the center of the cornea. The amount of tissue removed is dependent upon the degree of near-sightedness that is being corrected. This portion of the LASIK procedure is almost identical to the PRK

procedure, except that in the PRK the surface of the cornea is treated without the creation of the corneal flap.

In the final step, the hinged flap is folded back into its original position. The front surface of the eye is now flatter since the flap conforms to the underlying surface. In effect, the change made in the middle of the cornea is translated to the front surface of the cornea.

Other applications of Laser in Surgery

Skin Surgery Skin/Laser Surgery refers to the treatment of certain skin disorders by surgical means. It also includes the surgical treatment of certain conditions of the scalp and nails. In laser surgery, a precise and intense light beam is used to burn and destroy tissue. All of the above methods are usually performed under local anaesthesia, in some cases, no anaesthesia is required at all. Usually such surgical procedure will take less than 30 minutes to perform. The patient will usually be able to return home immediately after surgery and often, be able to resume work in a day or two.

Certain lesions on the skin or just beneath it can be treated by Skin/Laser Surgery. These include:

Growths of infectious origin, eg Viral Warts Birthmarks, eg: port-wine stains. Growths associated with ageing, eg: Rough spots, usually brownish, that look as if they are stuck on the skin. They commonly occur on the face of people over 40 years of age. Skin tags are soft, fleshy growths most commonly seen around the neck and in the armpits.

Advantages and disadvantages of Laser Surgery

Advantages of Laser Surgery

1. Results are good in cosmetic sense 2. Multiple lesions could be treated with laser surgery 3. Birthmarks and pigmented lesions could also be treated with laser which was considered as untreatable in past 4. Less complication after treatment.
Disadvantages of Laser Surgery

1. 2. 3. 4.

Laser surgery is costly as equipment are very costly Multiple laser could be required for treatment Any type of local infection could complicate laser treatment. Scarring or altered skin texture is also a possibility

References
Bellis, M n.d History of Lasers viewed 5th May 2009, http://inventors.about.com/od/lstartinventions/a/laser.htm Nasional Laser Doctor Referral, 2008 Cosmetic And Laser Surgery viewed 4th May 2009, http://www.lasertreatments.com