Acknowledgements |
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xi | |
Trainee Feedback |
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xiii | |
About the Author |
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xv | |
Glossary |
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xvii | |
Introduction |
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1 | (2) |
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0.1 Lasers in Ophthalmology (Diagnostic and Therapeutic) |
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1 | (2) |
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Section 1 Basic Principles of Laser |
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3 | (30) |
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3 | (6) |
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1.1.1 Properties of Laser Light |
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3 | (1) |
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1.1.2 Understanding Laser Physics |
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3 | (2) |
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1.1.3 How Does an Atom in the Ground State Move to an Excited State? |
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5 | (1) |
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1.1.4 Stimulated Emission |
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6 | (1) |
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7 | (2) |
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1.2 Parameters of Laser Light - Determines Its Tissue Biological Effects |
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9 | (2) |
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9 | (1) |
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10 | (1) |
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10 | (1) |
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10 | (1) |
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1.3 Laser Delivery Systems |
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11 | (5) |
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1.3.1 Slit Lamp Laser Delivery |
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12 | (2) |
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1.3.2 Binocular Indirect Ophthalmoscopy (BIO); Laser Indirect Ophthalmoscopy (LIO) |
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14 | (2) |
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1.4 Laser Tissue Interaction |
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16 | (4) |
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1.4.1 Principles of Laser Tissue Interactions |
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17 | (1) |
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1.4.2 Laser Mechanisms in the Retina |
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17 | (1) |
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1.4.3 Starling's Law and Macular Oedema |
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18 | (1) |
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1.4.4 How Does Focal Laser Treatment Reduce Macular Oedema? |
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18 | (2) |
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1.5 Laser Hazard and Laser Safety Protocols |
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20 | (3) |
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1.5.1 Laser Classification and Safety (ANSI Standards) |
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20 | (1) |
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1.5.2 Laser Safety Protocols |
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21 | (1) |
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1.5.3 Laser Safety Eyewear |
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22 | (1) |
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23 | (10) |
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1.6.1 Advantages of Contact Lenses in Lasers |
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23 | (1) |
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1.6.2 Safety Principles of Contact Lenses |
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24 | (1) |
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24 | (1) |
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1.6.4 Lens Classification |
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25 | (1) |
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1.6.5 Common Features of Laser Contact Lenses |
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25 | (1) |
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1.6.6 Lens Used with YAG Laser |
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26 | (2) |
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1.6.7 Contact Lenses Used in Conjunction with Photothermal Lasers |
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28 | (2) |
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30 | (3) |
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33 | (28) |
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33 | (2) |
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34 | (1) |
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2.2 YAG Laser Posterior Capsulotomy |
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35 | (13) |
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2.2.1 Pathophysiology of Posterior Capsular Opacification |
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36 | (1) |
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2.2.2 Posterior Capsular Opacification in Paediatric Patients |
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36 | (1) |
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2.2.3 Types of Capsular Opacification |
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37 | (2) |
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2.2.4 How Does YAG Laser Work? |
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39 | (1) |
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39 | (1) |
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2.2.6 YAG Capsulotomy Techniques - Two Main Techniques |
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40 | (1) |
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2.2.7 Treatment Procedure |
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41 | (2) |
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2.2.8 Size of the Posterior Capsulotomy |
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43 | (1) |
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2.2.9 YAG Capsulotomy with Eccentric Pupil |
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44 | (1) |
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2.2.10 Complications of YAG Capsulotomy |
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44 | (1) |
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45 | (2) |
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2.2.12 Newer Concepts in Posterior Capsulotomy |
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47 | (1) |
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2.2.13 Re-opacification of Posterior Capsule |
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47 | (1) |
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2.2.14 IOL Opacification/Calcification |
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47 | (1) |
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2.3 Capsular Block Distension Syndrome |
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48 | (2) |
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2.3.1 Pathophysiology of CBDS |
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48 | (2) |
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50 | (3) |
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2.5 Inflammatory Pupillary Membrane and Synechiolysis in Pseudophakes |
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53 | (3) |
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2.5.1 Clearance of Inflammatory IOL Deposits |
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54 | (1) |
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2.5.2 Clearance of Retained SLM in the Visual Axis |
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54 | (1) |
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55 | (1) |
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2.6 YAG Laser Vitreolysis |
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56 | (3) |
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57 | (1) |
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2.6.2 YAG Vitreolysis for Vitreous Wick |
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57 | (2) |
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59 | (1) |
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2.7 YAG Laser Hyaloidotomy |
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59 | (2) |
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60 | (1) |
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60 | (1) |
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Section 3 Lasers in Glaucoma |
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61 | (20) |
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61 | (1) |
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3.1.1 Outflow Enhancing Procedures |
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61 | (1) |
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3.1.2 Inflow Reducing Procedures (Aqueous Production) |
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61 | (1) |
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3.2 YAG Laser Peripheral Iridotomy (LPI) |
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62 | (8) |
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3.2.1 Indications for YAG LPI |
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62 | (1) |
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3.2.2 How Does YAG LPI Work? |
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62 | (1) |
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3.2.3 Laser Peripheral Iridotomy - Procedure |
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63 | (4) |
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3.2.4 Complications of LPI |
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67 | (2) |
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3.2.5 Sequential Argon/PASCAL Iridoplasty with Nd:YAG PI |
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69 | (1) |
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69 | (1) |
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3.3 Pigment Dispersion Syndrome (PDS) |
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70 | (1) |
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71 | (1) |
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3.4.1 Mechanism of Glaucoma |
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71 | (1) |
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72 | (2) |
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73 | (1) |
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3.6 Selective Laser Trabeculoplasty (SLT) |
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74 | (7) |
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74 | (1) |
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3.6.2 Mechanism of Action |
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75 | (2) |
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3.6.3 SLT Laser Technique |
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77 | (1) |
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78 | (1) |
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79 | (2) |
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Section 4 Photothermal Lasers |
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81 | (90) |
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4.1 Introduction -- Treatment Concepts and Current and New Laser Technology |
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81 | (4) |
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4.1.1 Current Concepts in Laser Photocoagulation |
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81 | (1) |
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4.1.2 New Laser Treatments/Technology |
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81 | (3) |
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84 | (1) |
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4.2 Getting Started with Laser Retinal Photocoagulation |
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85 | (5) |
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4.2.1 PASCAL Laser Machine |
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86 | (4) |
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4.3 Pan Retinal Photocoagulation |
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90 | (24) |
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4.3.1 Methods of PRP Delivery |
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91 | (1) |
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4.3.2 Normal Ocular Anatomy |
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91 | (2) |
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93 | (1) |
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4.3.4 Getting Started with Pan Retinal Photocoagulation |
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94 | (1) |
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4.3.5 Schematic Approach to PRP |
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95 | (5) |
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4.3.6 Understanding Laser Parameters for PRP |
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100 | (2) |
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4.3.7 Exceptions to Treatment Plan |
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102 | (3) |
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4.3.8 Aggressive Laser Treatment in Ischaemic Retinal Vasculopathy |
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105 | (2) |
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4.3.9 Pan Retinal Photocoagulation -- Procedure |
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107 | (1) |
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4.3.10 Starting PRP Treatment -- Lesson Based on Treatment-Naive Eye |
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108 | (4) |
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112 | (2) |
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114 | (6) |
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4.4.1 When Is Sectoral Laser Treatment Appropriate in BRVO? |
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114 | (2) |
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4.4.2 Sectoral PRP in BRVO or HRVO |
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116 | (4) |
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4.5 Focal Laser Treatment |
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120 | (29) |
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4.5.1 Indications for Focal Laser Treatment |
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121 | (1) |
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4.5.2 Is It Essential to Target Microaneurysms? |
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121 | (1) |
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4.5.3 Pre-Laser Investigations |
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121 | (14) |
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4.5.4 Grid Laser Treatment -- Including the Papillo-Macular Bundle |
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135 | (13) |
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148 | (1) |
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4.6 Focal Laser Treatment for Non-Diabetic Maculopathies |
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149 | (14) |
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4.6.1 Retinal Vein Occlusion |
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149 | (3) |
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4.6.2 Retinal Artery Macroaneurysm (RAM) |
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152 | (3) |
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4.6.3 Central Serous Chorioretinopathy (CSCR) |
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155 | (4) |
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4.6.4 Idiopathic Juxtafoveal Telangiectasia (IJFT) |
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159 | (4) |
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4.6.5 Laser Treatment for Age Related Macular Degeneration |
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163 | (1) |
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163 | (8) |
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4.7.1 Peripheral Retinal Degenerations |
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163 | (1) |
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4.7.2 Diagnosis of Retinal Holes and Tears |
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164 | (1) |
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4.7.3 Role of Posterior Vitreous Detachment |
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164 | (1) |
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4.7.4 Formation of Retinal Holes and Tears |
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164 | (1) |
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4.7.5 Operculated Retinal Holes |
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165 | (1) |
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165 | (1) |
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4.7.7 Treatment of Retinal Holes and Tears |
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166 | (1) |
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4.7.8 Laser Retinopexy -- Procedure |
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167 | (1) |
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168 | (1) |
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169 | (2) |
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Section 5 Approach to Retinal Vascular Disease |
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171 | (34) |
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5.1 Multimodal Treatment of Retinal Vascular Disease |
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171 | (3) |
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5.1.1 Anti-VEGF Agents Used Alone or in Combination |
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171 | (1) |
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5.1.2 What's `Visually Significant' DME? |
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172 | (1) |
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5.1.3 Real-World Implications of Visual Assessment |
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172 | (1) |
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172 | (2) |
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5.2 Approach to Diabetic Eye Disease |
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174 | (10) |
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5.2.1 Pathogenesis of Diabetic Retinopathy |
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175 | (1) |
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5.2.2 ETDRS Classification and Clinical Signs of DR |
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175 | (6) |
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5.2.3 Management of Diabetic Retinopathy |
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181 | (1) |
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5.2.4 Treatment Strategies |
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182 | (2) |
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5.3 Approach to Retinal Vein Occlusion |
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184 | (21) |
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5.3.1 Risk Factors for RVO |
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185 | (1) |
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5.3.2 Pathogenesis of RVO |
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185 | (1) |
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186 | (12) |
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5.3.4 Laser Treatment for Neovascularization |
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198 | (3) |
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201 | (4) |
Acknowledgement of Images Borrowed |
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205 | (2) |
Index |
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207 | |