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Laser and its medical

applications

S.SELVAKUMAR
ASSISTANT PROFESSOR
THAMIRABHARANI ENGINEERING
COLLEGE
TIRUNELVELI
9042474329(MOBILE)
kumartvl88@gmail.com(E-MAIL)
A wide application of laser in medicine and beauty therapy

Surgical laser: removing tumors, making incisions.
Cosmetic treatments: resurfacing, removal of birth
mark, age spots, spider veins, hair, tattoos,
Ophthalmology: inner eye surgery in removing
cataract, repairing retina, correct nearsightedness.
Laser
repairing retina
Laser removal of port-wine stain
Laser skin rejuvenation
Laser = Light Amplification by Stimulated Emission of Radiation
The physics of laser
The interaction of laser light with human tissue

What is a laser?
Simple atomic structure
Light emission
Characteristic of laser
Laser power and intensity
Mechanisms of laser interaction
with human tissues
Selective absorption of laser light
by human tissues
Applications of lasers in
healthcare and beauty therapy

Outline of the unit 11
1. Summary about atom
Atom is the smallest
building block of matters,
including body tissue and
fluids,
it is electrically neutral, it contains three elementary particles: the
electron , the proton, and the neutron.
electrons make circular motion around the nucleus (containing
proton and neutron) in different level of orbits, called stationary
orbits, they correspond to different energy levels.
the number of electrons is equals to the number of protons in an
atom,
a nucleus counts for vast majority of the atomic mass.
The so-called atomic number (Z number) is the proton number
(also electron number) in an atom. Ions are formed when atoms
obtained extra electrons or loose electrons.

2. Light emission
electron orbits displayed as an energy level diagram
energy is plotted vertically with the lowest (n=1) , or
ground stat, and with exited states (n=2, 3,4,) above.
n is called orbit number and can be only positive integer.
(a) The electron can absorb energy and jump to a higher level, the
process is called excitation.
(b) A photon is emitted when an electron change from a higher orbit
to a lower orbit with a characteristic emission spectrum. This
process is called de-excitation.
(c) If an atom absorbs a photon, an electron jumps from a lower orbit to a
higher orbit with a characteristic absorption spectrum.
Atom will absorb and emit light photons at particular
wavelength corresponding to the energy differences
between orbits. The wavelength l of emitted or absorbed
photon can be obtained by the formula:
hf
hc
E
l
where E is the change in energy between the initial and
final orbits.

A variety of biological molecules have notable absorption
spectra in the visible, IR, and UV. This has many clinical
application. e.g. Oximeter.
3. How laser works
Spontaneous emission and stimulated emission
An excited electron may gives off a photon and decay to the
ground state by two processes:
stimulated emission : the excited atoms interact with a pre-
existing photon that passes by. If the incoming photon has
the right energy, it induces the electron to decay and gives off
a new photon. Ex. Laser.
spontaneous emission: neon light, light bulb
Optical pumping
many electrons must be previously excited and held in an
excited state without massive spontaneous emission: this is
called population inversion. The process is called optical
pumping.
Example of Ruby laser.
Optical pumping
Only those perpendicular to the mirrors will be reflected
back to the active medium, They travel together with
incoming photons in the same direction, this is the
directionality of the laser.

Characteristics of laser
The second photon has the same energy, i.e.
the same wavelength and color as the first
laser has a pure color
It travels in the same direction and exactly in
the same step with the first photon
laser has temporal coherence
Comparing to the conventional light, a laser is
differentiated by three characteristics. They are:
Directionality,
pure color,
temporal coherence.
Characteristics of laser
Directionality

Temporal coherence
Pure color
where the unit of power is Joules/s or W.
The power and intensity of a laser
The power P is a measure of energy transfer rate;
The energy encountered by a particular spot area in a
unit time is measured by the intensity (or power
density):
)
2
2
(cm area spot
(W) Power
) (W/cm Intensity
(s) time exposurte
(J ) output energy Total
Power(W)
laser versus ordinary lights:
The directionality of laser beam offers a great advantage over
ordinary lights since it can be concentrate its energy onto a very
small spot area. This is because the laser rays can be considered
as almost parallel and confined to a well-defined circular spot on
a distant object.
Sample problem: we compare the intensity of the light of a
bulb of 10 W and that of a laser with output power of 1mW
(10
-3
W). For calculation, we consider an imagery sphere of
radius R of 1m for the light spreading of the bulb, laser
beams illuminate a spot of circular area with a radius
r = 1mm.
2 5
2 2
/ 10 8
) 100 ( 4
10
4
10
cm W
cm
W
R
W
A
P
I
bulb
bulb



2 2
2
3
2
3
/ 10 3
) 1 . 0 (
10 10
cm W
cm
W
r
W
A
P
I
laser
laser




400
/ 10 8
/ 10 3
2 5
2 2

cm W
cm W
I
I
bulb
laser
Fluence, F is defined as the total energy delivered by a
laser on an unit area during an expose time T
E
,
F(J /cm2)=I(watts/cm2) x T
E
(s)
The advantage of directionality of a laser : we can focus
or defocus a laser beam using a lens. This can be used
to vary the intensity of the laser.
Incoming
parallel ray
f
Focused spot
Diverged beam
continuous wave (CW) lasers versus pulsed lasers
CW lasers has a constant power output during whole operation
time.
pulsed lasers emits light in strong bursts periodically with no
light between pulses
usually T>>T
w
The t
w
may vary from milliseconds (1ms=10
-3
s) to
femtoseconds (1fs=10
-15
s), but typically at nanoseconds
(1ns=10
-9
s).
energy is stored up and emitted during a brief time t
w
,
this results in a very high instantaneous power P
i

the average power P
ave
delivered by a pulsed laser is low.
Instantaneous power P
i

w
pulse
i
t
E
P
Average power P
ave

R E
T
E
P
pulse
pulse
ave

Where R is the repetition rate
Example
A pulsed laser emits 1 milliJoule (mJ) energy that lasts for 1
nanoseconds (ns), if the repetition rate R is 5 Hz, comparing
their instantaneous power and average power. (The repetition
rate is the number of pulses per second, so the repetition rate is
related to the time interval by R=1/T).
W
s
J
ns
mlliJoule
t
E
P
w
pulse
i
6
9
3
10
10
10
1
1

W Hz J Hz R J E
T
E
P
pulse
pulse
ave
3 3
10 5 5 10 ) ( ) (


4. Mechanisms of laser
interaction with human tissues
When a laser beam projected to tissue
reflection,
transmission,
scattering,
re-emission,
absorption.
Five phenomena:
Laser light interacts with
tissue and transfers
energy of photons to tissue
because absorption occurs.
Photocoagulation
What is a coagulation?
A slow heating of muscle and other tissues is like a
cooking of meat in everyday life.
The heating induced the destabilization of the proteins,
enzymes.
This is also called coagulation.
Like egg whites coagulate when cooked, red meat turns
gray because coagulation during cooking.

A Laser heating of tissues above 50
o
C but below 100
o
C
induces disordering of proteins and other bio-molecules, this
process is called photocoagulation.
Consequence of photocoagulation
When lasers are used to photocoagulate tissues during
surgery, tissues essentially becomes cooked:
they shrink in mass because water is expelled,
the heated region change color and loses its mechanical
integrity
cells in the photocoagulated region die and a region of
dead tissue called photocoagulation burn develops
can be removed or pull out,

Applications of photocoagulation
destroy tumors
treating various eye conditions like retinal disorders
caused by diabetes
hemostatic laser surgery - bloodless incision, excision:
due to its ability to stop bleeding during surgery. A
blood vessel subjected to photocoagulation
develops a pinched point due to shrinkage of
proteins in the vessels wall. The coagulation
restriction helps seal off the flow, while damaged
cells initiate clotting.
Photo-vaporization
With very high power densities, instead of cooking, lasers
will quickly heat the tissues to above 100
o
C , water within
the tissues boils and evaporates. Since 70% of the body
tissue is water, the boiling change the tissue into a gas. This
phenomenon is called photo-vaporization.
Photo- vaporization results in complete removal of the tissue,
making possible for :
hemostatic
incision,or excision.
complete removal of
thin layer of tissue.
Skin rejuvenation,
resurfacing
Conditions for photo-vaporization
1. the tissue must be heated quickly to above the boiling
point of the water, this require very high intensity lasers,
2. a very short exposure time T
E
, so no time for heat to
flow away while delivering enough energy,
highly spatial coherence
(directionality) of lasers
over other light sources is
responsible for providing
higher intensities
Intensity requirement
Intensity (W/cm
2
) Resulting processes

Low (<10) General heating
Moderate (10 100) Photocoagulation
High (>100) Photo-vaporization
Photochemical ablation
When using high power lasers of ultraviolet wavelength,
some chemical bonds can be broken without causing local
heating; this process is called photo-chemical ablation.

The photo-chemical ablation results in clean-cut incision.
The thermal component is relatively small and the zone of
thermal interaction is limited in the incision wall.
5. Selective absorption of laser
light by human tissues
Selective absorption
Selective absorption occurs when a given color of light is
strongly absorbed by one type of tissue, while transmitted by
another. Lasers pure color is responsible for selective
absorption.
The main absorbing components of tissues are:
Oxyhemoglobin (in blood): the bloods oxygen carrying
protein, absorption of UV and blue and green light,
Melanin (a pigment in skin, hair, moles, etc): absorption
in visible and near IR light (400nm 1000nm),
Water (in tissues): transparent to visible light but strong
absorption of UV light below 300nm and IR over
1300nm
Selective absorption
6. Applications of lasers
Lasers in beauty therapy
Lasers application in beauty therapy are based on:
selective absorption of absorbing components.
photo-vaporization process for removal of the treated
components.
pulsed lasers are used.

Laser skin rejuvenation
IR lasers are used to remove extremely thin layer of skin
(<0.1 mm). In the absence of pigment in general, they take
advantage of the presence of water in the skin to provide an
ability to remove skin and body tissue.
Laser hair removal
selective absorption : absorbing component being melanin
pigment in hair and follicle, it is best worked with a red light
ruby laser. White hair can not be treated with any laser due to
the lack of absorbing component.
Laser removal of port-wine stain
Yellow laser
is absorbed
by the
presence of
hemoglobin
in blood
vessels.
Laser removal of tattoo
tattoo can be removed with
variety of laser depending
on the presence of inks in
the tattoo.
Lasers in ophthalmology
For retina operation, visible laser can be used. Visible light is
transparent to the cornea and crystalline lens, and can be focused with
eyes lens on the retina. The most popular visible laser is the green
argon laser.
Treatment of glaucoma: Argon laser is
focused externally on iris to make incision,
creating drainage holes for excess aqueous
humors to release pressure,
Retina tear: photocoagulation burn to
repair retina tears due to trauma to the
head.
Diabetic retinopathy: inadequate blood
supply to the retina due to diabetes. Small
photocoagulation burn by green argon
laser to repair the retina due to vessels
leakage.

Lasers in ophthalmology
For cornea and lens, UV light emitted by the excimer laser is
strongly absorbed by water and proteins, so their energy can be
absorbed by transparent cornea and lens, permitting laser
surgery on these areas.
Cataracts: a milky structure in the lens of the eye.
Photo-vaporization by using UV laser to remove the
obaque regions.
Correction of myopia: over focusing of the lens.
Excimer laser removal of surface of cornea to make it
flatten.

7. Laser hazards and protections
Absorption of the eye
Hazards to the eye
The retina
The directionality of a laser beam permits the ray to be focused
to an extremely small spot on the retina. A collimated laser will
be concentrated by a factor of 100,000 when passing from
cornea to retina.
Visible or near I R lasers (400 nm
to 1400nm) are particularly
dangerous to the retina and
always requires eye-protection
when working with these kind of
lasers.
Hazards to the eye
The cornea and lens
Cornea is accessible to danger of UV and most of IR lasers,
UV-A, UV-B (between 295nm and 320 nm) and IR-A
(between 1 to 2 mm) are dangerous for lens,
308-nm (UV-B) excimer XeCl laser is particular dangerous
because of it can simultaneously damage the lens, the cornea
and the retina.
Protection to the eye
Eye protection
Eyewear (goggles) is the most common laser protective
measure, especially for open laser beams. It should be good
design with all around shielding and adequate visible light
transmission.

Identification of the eyewear : All laser protective eyewear
shall be clearly labelled with information adequate to ensure
the proper choice of eyewear with particular lasers.