COLD LASER THERAPY IN OPHTHALMOLOGY

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LOW LEVEL LASER THERAPY IN OPHTHALMOLOGY

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    ALL ABOUT LASER THERAPY  

DR. Endy Portman MD

Tendopains. A patient suffering from severe pains in dorsal part of foot. The affected area was swollen and very sensitive. The case was diagnosed as Tendopain.

Following 2 treatments with the laser device Vityas (TerraQuant, RIKTA, MILTA), the area was less swollen, and following an additional 7 treatments, complete healing was noted, with completely free movement of the foot

Andy S. Gortnev

With my extensive experience working with chronic and acute injuries Vityas Laser (TerraQuant, RIKTA, MILTA) is the most advanced and effective modality which I use for many world class athletes as well as lay people.

Dr. Bred Lohnson

Soft tissue injuries & musculoskeletal inflammation. Pain management needs addressing from several ways - often more than tablets is required. I have used the RIKTA (TerraQuant, MILTA, Vityas) device to successfully treat soft tissue injuries and other musculo-skeletal inflammatory disorders e.g. tennis elbow. It combines the power of three modalities to treat the conditions and yet at the same time its use remains easy enough for patients to use with excellent instructions. The TerraQuant is ideal unit to use in a General Practice setting, training requirements being kept to a minimum and yet the unit appears very safe to use.

A.D. Dr. Greg Fertman

Fractures. 25-year-old male who sustained a mid-shaft fracture of the humerus on 20th July in Darwin while pitching a baseball. He was treated conservatively in Darwin. After 6 weeks he came to Melbourne and complained of pain around the upper arm and in the cubital fossa area.

After investigating him for osteoporosis (neg.) he was started on low-level laser therapy by Vityas Device (TerraQuant, MILTA, RIKTA ) and given exercises to increase strength around the elbow and shoulder.

He showed good recovery after 14 days' treatment as regards, pain but returned 1 week later, requesting further treatment from which he derived significant improvement.

LOW LEVEL LASER THERAPY IN OPHTHALMOLOGY

O.P.Pankov
Academic Ophthalmologic Center of Laser Academy of Sciences of Russian Federation,
Russia, Zhukovsky

First applications of low-level laser therapy of ophthalmic diseases began after the investigations of L.A.Linnik with co-authors in 1976-1978 in Odessa SRI of Ophthalmic Diseases and Tissue Therapy named after academic V.P.Philatov. For the first time the authors managed to fix experimentally the fact of the increasing DNA syntheses in the nuclei of ganglionic cells of retina under the influence of low-level laser therapy, which results in the increasing cell resistance to the influence of unfavorable factors and the rise of their functional activity.

The authors were also the first to fix the increasing functional activity of the epithelium and endothelium of the cornea, and the epithelium of the front bursa of lens.

This research caused further elaboration of clinic methods of low-level laser therapy of ophthalmic diseases and their experimental basis.

M.M. Krasnov with co-authors offered the method of the stimulation of the area of macula lutea in cases of dry maculodystrophy by 2-3-minute illumination by a parallel non-focused beam of helium-neon laser, working in the modulation mode (the frequency of pulse repetition is 10 Hz), with outlet power 0.25 mW. No more than 3 sessions with 7-10 days interval are held. When the mentioned above method of helium-neon laser stimulation is applied 93% of the patients with dry dystrophy of macula lutea show the increasing visual acuity of different degree, the improvement of the macular tests indexes, the increasing volume of the modulate critical frequency of the fusion of the light flickering.

G.A.Uldanov (1982) established a sure speeding up of the visual function regeneration of the patients operated on amotio retina, resulting from the given courses of helium-neon laser stimulation (10-15 everyday sessions with the 1-2 minutes exposition).

There is information about positive results of laserstimulation with the use of low-level helium-neon and argon lasers with functional amplyopia of various genesis (E.A.Avetisov and others, 1977).

A.I.Zolotareva, A.F.Belyanin (1982) publish the observation of the results of helium-neon laser application (outlet power 2 mW, the power density of the surface of cornea 0.1 mW/cm2) to 56 patients with false traumatic and hemolytic nonmophthalms with the case history from one day in some cases to several months, with the visual acuity within the limits of photoperception and the lack of reflex from the eyegrounds. After the course of laser therapy (6-10 everyday 1-3-minute sessions), 49 patients showed the improvement of the optic characteristics of the vitreous body, 43 developed a subject vision. In long terms (up to 2 years) 31 observed patients (from 42) with false and hemolytic nonmophthalms showed the improvement of visual function.

The first publication about the positive effect of the helium-neon laser application in the treatment of flabby-going post-traumatic iridocyclitis and long-healing ulcers of the cornea belongs to V.D. Starodubtsev (1979). A.D.Semenov with co-authors (1979) was one of the first who informed about the successful use of helium-neon laser (density power 0.05 mW/cm2) in the treatment of cornea dystrophy, appearing after the operation on the eyeball. The cornea was subjected to 3-5 minute irradiation, and so were healthy perilimbus zones 3-5 mm wide. The course of treatment consisted of 8-10 sessions with a day interval. The courses were repeated in 3-6 months. Under the influence of laserstimulation the pain disappeared in the eyes of 91% of patients, visual functions of 75% of patients improved, 81% of patients had a complete or partial restoration of the cornea sensitivity. In long periods (3-4 years) a steady curing effect of 64% of the examined patients was observed. The best results were obtained with laserstimulation of the dystrophic process of cornea on early stages (up to 6 months from its start).

In the following works of different authors there has been noted a high effectiveness of the application of low-level helium-neon laser therapy in the complex treatment of patients both with endothelial-epithelial dystrophy and traumas, burns of cornea. manifesting itself in the restoration of limpidity and sensitivity of the cornea, the increasing visual acuity and earlier completion of regenerating processes compared to the control group of patients.

Experimental research stated that low-level helium-neon laser therapy with the density of power flow 0.05-0.1 mW/cm2 with the exposition from 1 to 10 minutes aids the activation of proliferate and regenerative processes in the cornea in the case of its injury and doesn't cause irradiation injury of the retina.

According to the observations of L.A.Linnik and P.P.Chechin a successive combined use of low-level radiation of argon and helium-neon lasers influences much more effectively (than the use of only helium-neon laser) on the stimulation of reparative processes in the cornea in cases of its hard injuries, in particular, of long-healing ulcers.

Almost all above-mentioned publications note that the use of low-level laser therapy in the treatment of ophthalmic diseases didn't cause any local or general complications. But experimental investigations showed the possibility of unwanted side effects of the eye laserstimulation. Thus, G.L.Ukhaneva with co-authors (1985) registered edema and destruction of external layers of retina, and also the increasing intraocular pressure from 26-29 mm Hg with the effect of lymphostasis in the membranes after the irradiation of a rabbit eye by helium-neon laser with the power 1 mW. It is established that the influence of the energy of the radiation of the low-level helium-neon laser on the peripheral part of the visual analyzer of the females of white non-linear rats of sexual mature age results in the change of their sex cycle, the increasing number of abortion. They also inform about the case of decompensation of intraocular pressure of a patient with hyphemia on an eye after a single 1-minute irradiation by helium-neon laser with density on the cornea not more than 0.1 mW/cm2 (O.B.Chentsova with co-authors, 1988).


Experimental study of lymphostirnulating laser radiation on the development of dystrophic changes in eye tissues.

Experimental investigations of V.AXashuba and A.V.Cherkasova, 1988) proved that during the irradiation of an eyeball by helium-neon laser (wavelength 0.63 ìm) the radiation penetrates into retrobulbar tissues. Coming out of an eye radiation has a directed-dispersed character. In the total, the back hemisphere of an eyeball transmits up to 15% of laser radiation. The luminescence of the optic nerve indicates that nerves also serve as certain conductors of light, and their optic characteristics may influence the transmission of nerve impulses. Coming through eye-surrounding soft tissues and ossa cranii laser radiation reaches the cerebral cortex (0.2-0.9% at every measured point).

So, relying on the above-listed experimental and clinic data one can assume that laserstimulation of the front part of eyes also activates the drain of the back parts of retina and optic nerve, clearing the neuroreceptor system from metabolic product, thus preventing the development of dystrophic changes in retina and optic nerve.

To prove this hypothesis, we carried out an experimental study of the eye neuroreceptor system condition according to the data of computer electroretinography on our experimental model of dystrophic form of myopia.

There were conducted 2 series of experiments (16 eyes, 8 rabbits, 8 eyes in each series). In the first series of experiments the rabbits developed myopic disease under the influence of provoking enzyme (papain) administered into the zone of an eye equator. In the second series of experiments immediately after the administering of the enzyme the zone of the equator was irradiated by a helium-neon laser with the outlet power density 0.5 mW/cm2. The irradiation was repeated twice with a 3-day interval. After 6-12 months of observation in the second series under "the protection of laser radiation" the myopic disease didn't develop. The computer ERG showed that in 6 months after the beginning of the experiment the retina of the experimental animals didn't develop dystrophic changes according to ERG data. And in the control series there was registered a clear 40-60%o decrease of the amplitude of the wave "v" of the electroretinogram compared to the experimental group.

In the retina of the experimental eyes one can note the decrease of neurone density in the external nuclear layer, the distortion of the structure of the external segments of photoreceptors, especially in reactive thinness of sclera, edema in the layer of ganglionic cells. As in the optic nerve, low-level laser therapy shows its stimulating effect on the substituting vegetation of glial tissue in the injured retina. One should note the therapeutic effect oflow-level laser sources, manifesting itself mostly in injured tissues of an eyeball.

The study of gernodynamics by the method of rheoophthalmology in the I series of experiments confirmed the progressing lowering of the ROG compared to the second series of experiments where the ROG amplitude was close to the norm. Thus, our research showed the protective action oflow-level laser therapy on the development of dystrophic processes


The clinic research of lymphatic drain of the eye under the influence of low-level laser therapy according lo lymphoangiography data.

Totally 26 eye of 15 patients with dystrophic diseases of the organ of vision (dystrophy of retina, atrophy of the optic nerve, glaucoma, high complicated myopia) were subjected to laserstimulation. Their vision acuity, visual field (including he study on the peritest), macular tests were studied in dynamics. The function of lymphatic system was studied in dynamics by lymphoangliography of bulbar conjunctiva according to the method of Shmyireva V.F. and Fridman N.V. Totally 63 lymphoangiographic studies were carried out in 26 eyes (before laserstimulation, immediately after the session and in dynamics after the course of laserstimulation.

Results. On the second day after the laserstimulation session all patients demonstrated subjective improvement of vision. The analysis of the eye acuity study showed that after the course of laserstimulation it increased in 24 eyes, in one eye it remained the same and in one eye it lowered from 0.7 to 0.5. The improvement of the visual acuity is clearly manifested in cases of the initial visual acuity 0.3-0.5. Thus in the case of the patient with maculodystrophy it increased from 0.5 to 1.0, and in the case of the patient with glaucoma of III-IV degree the visual acuity increased from 0.01 to 0.1. The indexes of macular tests improved in 25 eyes (from 26).

Patients with glaucoma when tested on peritest demonstrated the decreasing quantity of microscotomas after the course of laserstimulation. The vision field expanded in all studies and in some cases - considerably.

The biomicroscopic study of the microcirculatory bed of conjunctiva after laserstimulation demonstrated the contraction of ischemic avascular zones, the trichangiectasia and venulectasia, distinct appearance of additional quantity of functioning rnicrovessels.

Of a special interest for the understanding of the laserstimulation mechanism are the results of the study of lymphocirclilation in these eyes. Thus, immediately after the laserstimulation session, all characteristics of lymphocirclilation (pic. 3) increased, beginning with the growing quantity from 2.090.41 to 2.450.56) and the calibre of lymphovessels (from 0.15 0.02 to 0.230.05) and ending with the speed of lymphocirculation which increased almost twice (from 1.670.49 to 3.031.71 mm3/min.). The given changes were found in all eyes. The volume speed of lymphocirclilation after laserstimulation in some cases was 37 and even 60 times more than the initial one.

After the course of laserstimulation the characteristics of lymphocirculation have a tendency to decreasing. The quantity oflymphovessels decreased from 2.090.41 to 1.360.58, their average calibre - from 0.130.02 to 0.100.01, the linear speed of lymphocirculation - from 3.441.06 to 2.170.88. The volume speed of lymphocirculation - the integral characteristic of lymphocirculation, after the course of laserstimulation was practically on the initial level - from 1.670.09 to 1.900.56 mm3/mm.

Discussion. Thus, based on lymphoangiographic research, we discovered a new biologic phenomenon - the activation of lymphocirculation in the conditions of pathology under the influence of organized laser therapy. Alongside with it, it was established that immediately after the session of laser therapy the intensification of lymphocirculation takes place - the increasing of quantity and calibre of functioning lymphatic vessels and the speed of lymphocirculation. And the decreasing of the lymphocirculation intensity indirectly indicates the decreasing need of the eye tissues in lymphatic drain during the process of step-by-step regeneration of visual functions.


The perspectives of the development of low-level laser therapy in ophthalmology.

Extremely slow introduction of low-level laser therapy into the practice of ophthalmologists is restricted by the lack of good methodological recommendation and modern equipment adopted to the needs of ophthalmology. The most perspective is considered to be further improvement of the methods and the elaboration of the medical equipment, working in several wave bands (infrared, red, green and blue), combined with magnitotherapy and working with the use of various modes of the modulation of the intensity of the luminous flux. It may be asserted that unlike the mode of continuous radiation, in some cases, the effectiveness of the treatment increases when the modulated light with the frequency of one to a few tens Hz is used. Moreover, the methods are being elaborated, when the modulation frequency of laser light and the biorhythms of man physiologic parameters (heart activity, respiration, visual perception) are synchronised. Very perspective seems the computerisation of the treatment process with the simultaneous electrophysiologic control of the condition of visual functions.

 

1 TRAUMATOLOGY and Quantum therapy laser acupuncture Vityas:

 

1.1 arthritis,  arthrosis

1.2  ARTHRITIS,  GONARTHROSIS

1.3   ARTHRITIS,  HIP  JOINT ARTHROSIS

1.4  ARTHRITIS,  RADIAL  WRIST  JOINT  ARTHROSIS

1.5 ARTHRITIS,  ARTHROSIS OF PHALANGES OF  HAND  AND FOOT

1.6 CALCANEAL SPUR

1.7 OSTEOCHONDROSIS OF BACK BONE, RADICULITIS

1.8 NEURODYNIA

1.9 BONE FRACTURES

1.10 CONCUSSIONS, hydradenites

1.11 OPEN WOUNDS

1.12  TROPHIC  ULCER, LONG  OPEN  WOUNDS, DECUBITUS

1.13 HUMEROSCAPULAR PARASYNOVITIS

1.14 MYSITIS, PERITENDITIS, SPRAIN

2 SKIN DISEASES and cold laser device Vityas:

2.1 DERMATITIS, ECZEMA

2.2 FURUNCULOSIS, VERRUCAS

2.3 HERPES OF SKIN AND GENITAL ORGANS

2.4 WRINKLES

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1.1   ÀRTHRITIS,  ÀRÒHROSE

1.2  Gonitis,  Gonarthrose

1.3  Koxitis,  Koxarthrose

1.4 Arthritis -, Arthrose des proximalen Handgelenkes

1.5  Fingerarthritis, Fingerarthrose

1.6   Fersensporn

1.7 Osteochondrose, Radikulitis

1.8   Neuralgie

1.9 Knochenbruch

1.10 Schweißdrüsenabszeß, Kontusionen

1.11 Îffene Wunden

1.12 Trophisches Geschwür, Dekubitalgeschwür, Wunden  mit der grossen Heilungsdauer

1.13 Duplay Krankheit

1.14 Myositis, Tendovaginitis, Muskel- und Sehnenzerrung

 

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