New laser modalities for posterior segment treatment

Laser light is currently used for photocoagulation and photoresection in the posterior segment of the eye. Randomized controlled clinical trials on huge caselists, employing rigorous methodology, have confirmed the efficacy of photocoagulation treatments in numerous retinal pathologies. On the basis of the findings of these trials, precise treatment protocols have been drawn up. Nevertheless, some doubts persist on the indications and exact modalities for laser treatment in certain clinical forms. While the various treatment protocols were being defined, research was focusing on the development of new equipment that would maintain at least the same level of therapeutic efficacy as conventional apparatus while offering advantages in reliability, costs, ease of handling, and working life. An important product of this line of research is the semiconductor diode laser photocoagulator. The new frequency-doubled neodymium:yttrium-aluminum-garnet laser and the continuous wave neodymium:yttrium-aluminum-garnet laser hold promise for contact photocoagulation. Photoresection is acknowledged now as an important means of dealing with vitreoretinal lesions. It provides an adequate solution in selected cases of vitreoretinal pathology and serves as a useful adjunct in conventional surgery.