[Lasers in ophthalmology].

The optical accessibility of almost all its structures predestines the eye for the application of lasers for diagnostic and therapeutic purposes. The lasers presently used in ophthalmology are listed in the table. We can distinguish among five different kinds of tissue change caused by lasers: photocoagulation, photovaporization, photodisruption, photodynamic effect, and photo-ablation. Photocoagulation therapy is used in vascular diseases of the retina, particularly diabetic retinopathy, in macular disease, especially senile macular degeneration, in retinal surgery as a prophylaxis for retinal detachment, as well as in glaucoma surgery. Completely new surgical dimensions have been made possible by photodisruptive therapy, including very specific, microsurgical tearing and shredding, even of transparent structures such as the posterior lens capsule after extracapsular cataract operation and posterior lens implantation, or of vitreal strands. Photodynamic therapy is applied together with hematoporphyrins in the treatment of malignant melanoma. At present, we are fascinated with the development of the excimer laser, which promises to provide photoablative corneal surgery without mechanical deformation of the eye.