Marshall J
Institute of Ophthalmology, University College London, London, UK.
Eye (Lond). 2015 Jan;29(1):46-64. doi: 10.1038/eye.2014.240.
To describe the historical evolution of the role of lasers in effecting therapeutic changes in the four acellular membranes of the eye. Over the past 50 years, iterative developments have been instituted in lasers used for various forms of eye surgery predominately on the basis of data generated in early experiments in the 1960s to determine thresholds for damage and their incorporation in codes of practice for laser safety. The evolutionary steps are described. Excimer laser technology resulted in the generation of the new field of laser refractive surgery with over 40 million individuals now having undergone procedures such as photorefractive keratectomy and LASIK. Developments in lasers used for various forms of retinal surgery have undergone changes involving shorter and shorter pulse durations together with changes in beam energy distribution with implications for potential intervention in AMD prophylactically. Lasers have made a major impact on surgical treatment on all four acellular membranes of the eye but particularly Bowman's membrane in refractive surgery, where it has been demonstrated that it can be removed without significant consequences for eye health or vision.
描述激光在影响眼部四层无细胞膜治疗性变化中所起作用的历史演变。在过去50年里,主要基于20世纪60年代早期实验所产生的数据,为确定损伤阈值并将其纳入激光安全操作规范,用于各种眼科手术的激光技术不断迭代发展。文中描述了这些演变步骤。准分子激光技术催生了激光屈光手术这一全新领域,如今已有超过4000万人接受了诸如光性屈光性角膜切削术和准分子原位角膜磨镶术等手术。用于各种视网膜手术的激光技术发展涉及脉冲持续时间越来越短,以及光束能量分布的变化,这对年龄相关性黄斑变性的预防性干预具有潜在意义。激光对眼部所有四层无细胞膜的手术治疗都产生了重大影响,尤其是在屈光手术中对鲍曼膜的影响,已证明去除该膜对眼睛健康或视力不会造成重大影响。