Laser light: its nature and its action on the eye

Lasers produce a coherent, focused, monochromatic, high-energy form of light. Because laser surgery is more versatile and precise and is freer of complications than conventional surgery it has become widely accepted in ophthalmology over the past 10 years. Applications range from routine procedures in the fundus to recent, more delicate interventions in the cornea. The argon laser is the most widely used to treat extrafoveal chorioretinal diseases such as age-related macular degeneration and diabetic retinopathy; it has also been used successfully to treat glaucoma by iridectomy or trabeculoplasty. The krypton red laser is the argon laser's counterpart in the treatment of subfoveal and pigment-epithelium-related diseases. Posterior capsulotomy is the most widespread and successful intervention with the neodymium:yttrium-aluminum-garnet crystal laser; this laser is also used to cut vitreous traction bands and is increasingly used in iridectomy. Although the use of the excimer laser in corneal surgery is still largely investigational it has been shown to produce precise cuts in corneal layers for the correction of myopia or astigmatism. The variable-wavelength dye laser, capable of reaching a specific level in the retina or choroid, has offered exciting new developments, and it promises to soon be part of the ophthalmologist's armamentarium in the treatment of eye disease.