Fifty years of ophthalmic laser therapy.
نویسندگان
چکیده
L ASER IS A CATCHY SCIENTIFIC ACRONYM THAT we associate intuitively with precision and sophistication, novelty and ingenuity, power and adaptability. Since its invention more than 50 years ago, it has revolutionized and enabled a long list of technologies, from telecommuni-cation to imaging, from lithography of integrated circuits (the brains behind electronic devices) to rapid DNA sequencing, from missile defense to printing. The first medical application of the laser, which occurred less than a year after its invention, was retinal photocoagulation; since then, its effect on ophthalmology is hard to overestimate. Now, lasers are used in all ophthalmic subspe-cialties; they are critical for many diagnostic and therapeutic devices. This article reviews the history of ophthalmic therapeutic lasers, from the original concepts to technological breakthroughs that have helped to shape modern oph-thalmology. We highlight the story of the initial discovery of the technology and the translation of lasers to oph-thalmology, with some personal insights from people who were there. However, we make no attempt to cover all aspects of current laser therapy or the many researchers who have worked in the field. EARLY HISTORY The damaging effects of strong light on vision were known in Plato's time, as he describes Socrates' admonition to avoid direct viewing of a solar eclipse. 1 A medieval description of central vision loss from gazing at the sun was provided by Theophilus Bonetus (1620-1689). 2 The concept of ocu-lar therapy using light first was harnessed and publicized by Meyer-Schwickerath, who took patients to the roof of his laboratory in 1949 and focused sunlight on their retinas to treat melanomas. In his groundbreaking book, 2 he notes that the first experiments on retinal damage from sunlight were performed by Czerny in 1867 and others in the late 1800s. In 1927, Maggiore demonstrated light damage in a human eye scheduled for enucleation. In the 1940s, Mó ran-Salas was doing extensive experiments on rabbits and humans with the aim of therapeutic coagulation. However , he was not satisfied with the effects and did not publish his results until after Meyer-Schwickerath (who had been unaware of this work) had reported his own findings. As with many aspects of science, discovery requires recognition to be successful; Meyer-Schwickerath demonstrated that photic burns could be beneficial therapeutically. But the technique was hardly practical for wide use, and therapy was limited because it required sunny weather. Thus, nonsolar sources were sought. Carbon arcs were …
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ورودعنوان ژورنال:
- Archives of ophthalmology
دوره 129 12 شماره
صفحات -
تاریخ انتشار 2011