Laser applications for corneal disease

The clinical use of the carbon dioxide (CO2) laser and diode laser is increasing in veterinary medicine. New applications for their use are being explored, including ophthalmic applications. The use of lasers for small-animal corneal disease is fairly limited due to several factors. The ideal laser for corneal use is the excimer laser due to its extremely precise photoablative capability. However, the excimer laser is unlikely ever to become practical for veterinary use. The frequency of corneal disease in small animals in which tissue ablation is indicated is relatively low. And for most of these diseases, routine surgical techniques work as well or better than laser ablation. The CO2 laser can be used on corneal tissue, but must be used very cautiously so as not to ablate too deeply, creating serious scarring or perforation. There are also concerns regarding its effect on corneal nerves, stromal collagen, and corneal endothelium. The CO2 laser can be very effective in ablating limbal tumors with corneal extension. The use of the laser is less invasive, technically less difficult, and faster because of excellent hemostasis. The diode laser, due to its high melanin absorption, can be used effectively to ablate epibulbar melanomas with corneal stromal invasion.