The History of Laser Photocoagulation

Introduction

How did we arrive at laser photocoagulation to treat eye conditions? The idea actually began with light photocoagulation first.

Light Photocoagulation

The idea of using light to purposely coagulate retinal tissue is credited to German ophthalmologist Gerd Meyer-Schwickerath from Essen, Germany.

He had observed earlier that a retinal scar stopped a progressive retinal detachment. Later, he saw the effects of a solar eclipse on the retina of a student, and then began looking for a way to use light to purposely coagulate retinal tissue.

He experimented with natural sunlight, a heliostat and a carbon arc lamp. Eventually Dr. H. Littman developed the xenon photocoagulator and this was manufactured by Carl Zeiss for him.

Between 1955 and 1959, light photocoagulation was being used in the treatment of diabetic retinopathy with mixed success. Other conditions treated by light photocoagulation included Leber’s aneurysms, Eales’s disease and angiomatosis.

The drawback of this technique included long exposure times and large size of the lesions.

Laser photocoagulation

 In 1960, Theodore Maiman developed the first laser, a Ruby laser, while working at Hughes Research Laboratory in California. The era of laser photocoagulation was born. Charles Campbell in 1965 reported using the laser to treat retinal tears, peripheral degenerations, retinal detachments, angiomas, retinoschisis and focal chorioretinitis.

 Schott in 1964 and Gerd Meyer-Schwickerath and Schott in 1968 presented the results of laser photocoagulation in diabetic retinopathy.

 Beetham and Aiello published their series of treatment of proliferative diabetic retinopathy in 1969. Treated eyes did better than the other untreated control eye of the patient.

 The NEI Diabetic Retinopathy Study and the Early Treatment of Diabetic Retinopathy Study would seal laser photocoagulations primary role in the treatment of diabetic retinopathy for decades to come.

 

Reference: 

Light coagulation; a method for treatment and prevention of the retinal detachment. MEYER-SCHWICKERATH G. Albrecht Von Graefes Arch Ophthalmol. 1954;156(1):2-34.

Treatment of diabetic retinopathy by light-coagulation: A preliminary study. WETZIG PC, WORLTON JT. Br J Ophthalmol. 1963 Sep;47:539-41.

Diabetic Retinopathy and Photocoagulation. Gerd R.E. Meyer-Schwickerath, K. Schott

American Journal of Ophthalmology. Volume 66, Issue 4, Pages 597

Stimulated Optical Radiation in Ruby. T. Maiman. Nature 187, 493-494 (1960)

Beetham WP, Aiello LM, Balodimos MC, Koncz L. Ruby-laser photocoagulation of early diabetic neovascular retinopathy: preliminary report of a long-termcontrolled study. Trans Am Ophthalmol Soc. 1969;67:39-67