The word LASER is an acronym for Light Amplification by Stimulated Emission of Radiation. In this instance, the term radiation applies to light energy only.
The Nd: YAG Laser emits short, individual pulses of focused infrared electromagnetic radiation with a wavelength of 1064nm, which is invisible to the human eye. Nd: YAG is an abbreviation for Neodymium Yittrium Aluminium Garnet, often referred to as YAG.
The YAG is a modern laser system for photo disruption, or the fragmentation of tissue structures in the eye without any need for surgical intervention. Many improvements in design have been made and photo disruption laser applications are now considered very safe.
All YAG laser applications require highly specialised ophthalmology skills, which are available at the EyeS.
Treatment of secondary cataract. This accounts for 95% of the YAG therapy modalities. A cataract causes clouding of the lens nucleus, leading to an impairment of vision. After cataract surgery with the implantation of a posterior chamber lens (IOL) clouding of the remaining posterior lens capsule can occur in some cases. This can cause a considerable impairment of vision (“secondary cataract”), and a posterior capsulotomy is required. This treatment consists of opening the centre of the posterior lens capsule with the aid of a YAG laser.
Clusters of cells are sometimes deposited on the surface of implanted intraocular lenses, making the lens cloudy or opaque. The YAG laser is used with very low energy to remove these deposits from the surface of the IOL. This would appear to occur primarily with the now increasingly used silicone lenses.
This application, is performed in preparation for capsulorhexis (opening of the anterior capsule wall) as part of cataract surgery
Treatment for lowering intraocular pressure when flow of aqueous humour
between the lens and the iris is blocked. A hole is created in the iris with
the YAG laser.
The terms iridectomy and iridotomy are often used as synonyms. They are understood
to mean the production of a filter aperture in the iris. This treatment is
performed when there is an obstruction in the flow of aqueous humour between
the crystalline lens and the iris (angle-closure glaucoma and chronic glaucoma
with a narrow chamber angle); the aim of the treatment is to reduce the intraocular
pressure (IOP) or to prevent the same condition in the partner eye in the
case of acute glaucoma.
Treatment of glaucoma. An opening is created with the YAG laser in the tissues responsible for the the outflow of aqueous humour, in cases of obstruction or blockage. Trabeculotomy is rarely performed with the YAG laser. A generalised form of trabeculotomy is goniotomy. Here, the fluid outflow chamber angle is deepened with the aid of the YAG laser. Indications for goniotomy include primary congenital glaucoma found mainly in infants, and juvenile glaucoma as a special form of open-angle glaucoma.
Synechiae is an adhesion of the iris to surrounding tissue. The YAG laser can treat anterior (adhesion around the cornea) and posterior (adhesion to the lens) synechiae. Anterior synechiae can, for instance, occur after corneal transplants, starting from the edges of the wound. Posterior synechiae can occur in angle-closure glaucoma.
Treatment in which vitreous strands and membranes are severed with the help of a YAG laser. This is done in order to avoid the risk of traction on the retina which could lead to retinal detachment. This is only performed by experienced retinal consultants.
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