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Laser surgery

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Laser Surgery in Ophthalmology

Background
Surgery has evolved remarkably over the past centuries. While the knife traditionally has been regarded as the most important tool, new medical devices including lasers have broadened the extent of surgical techniques.
Lasers were originally used in ophthalmology in the early 1960s. Since then, many benefits of laser surgery in ophthalmology have been demonstrated.

What Are Lasers?
Lasers are surgical devices that use extremely high energy light waves in order to cut through tissue in a very accurate manner, and to coagulate and remove tissue. Lasers have produced dramatic surgical effects that have improved the quality of care for patients.

What Is Laser Surgery?

Like other surgical procedures, laser surgery alters, removes, replaces and reshapes human tissue, or it activates drugs for the purpose of treating disease and improving patient function and well-being. Because laser energy possesses remarkable strength, unlike ordinary light energy, lasers are used as sophisticated surgical instruments to produce definitive and precise surgical effects.
Lasers are used for many surgical applications. For example, Eye M.D.s (ophthalmologists) can perform laser surgery to help reduce vision loss from diabetic retinopathy and age-related macular degeneration, to restore vision when posterior capsular clouding occurs after cataract surgery, to reduce intraocular pressure in patients with glaucoma, to help reduce or eliminate the need for glasses, to remove cancerous lesions inside the eye or for cosmetic treatments of the eyelids.

Who Can Perform Laser Surgery?

The quality of care of patients undergoing laser surgery is a concern of your Eye M.D. and the American Academy of Ophthalmology. This quality of care should be safeguarded in the same way that it is for patients undergoing any surgery because the clinical complexities and potentially harmful consequences are similar.
As with any surgical procedure, the key to a successful outcome is a knowledgeable, experienced and skillful surgeon. The surgeon who uses lasers should understand the technology, be well trained in its use, be capable of managing potential complications and meet the high standards of his or her medical peers.
Eye M.D.s (ophthalmologists) have been among the principal pioneers and innovators in the field of laser surgery. They learn and gain mastery of laser surgery techniques through residency and fellowship training, continuing educational courses and preceptorship opportunities.
The Academy strongly supports the position that all laser surgery for medical purposes, including ophthalmic laser surgery, should be performed only by licensed doctors of medicine or osteopathy.

Possible Side Effects of Laser Surgery

Like other surgical instruments, lasers are potentially dangerous. Specific risks associated with lasers that are used for ophthalmic surgery include bleeding, increase in intraocular pressure, cornea clouding, retinal scarring and cataract formation. Each of these complications could result in significant loss of vision.

Guidelines

Because of the potentially harmful medical consequences of laser surgery, and in order to guard against unsafe or inappropriate use of lasers, strict guidelines have been established for the use of lasers in patient care. The FDA regulates all medical instruments as prescription devices, including ophthalmic lasers. In addition, several surgical specialty societies have developed guidelines and policies that set forth criteria for the medical qualifications of surgeons practicing laser surgery.

Patient Outcome

The best possible outcome for a patient after laser surgery depends on an accurate diagnosis, consideration of the patient's health status and visual needs, choice of an appropriate treatment given the spectrum of alternatives, timing of treatment and the proper use of prescription drugs postoperatively. As with any sophisticated surgery, patient outcome is also determined by the technical skill and experience of the surgeon. Lastly, patient outcome depends on the correct and timely recognition and management of both the anticipated and unforeseen secondary effects of the treatment.