The Nd YAG (Neodymium-doped Yttrium Aluminum Garnet) laser is a versatile and widely used solid-state laser.
Nd laser was first demonstrated by J.E. Geusic in 1964. Neodymium (Nd) selected for laser ion due to strong energy transitions for high-power lasers.
YAG crystal’s superior thermal properties ideal for continuous and pulsed laser operations.
A crystal of YAG doped with neodymium ions. The doping concentration ranges from 0.5% to 1.4%.
Nd³⁺ ions energized with flash lamps or laser diodes in an optical resonator with two mirrors amplify light through stimulated emission.
Laser beams used for cutting and welding can be pulsed for high peak power in bursts. YAG crystals enable continuous operation.
Indications
The Nd YAG laser indicated in various fields including medicine, ophthalmology, dermatology, surgery, and aesthetics.
Posterior Capsulotomy
Peripheral Iridotomy
Vitreolysis
Hair Removal
Pigmented Lesions
Soft Tissue Surgery
Oral Lesion Removal
Tumor Debulking
Contraindications
Absolute Contraindications are:
Active Infection at the Treatment Site
Malignant Lesions
Epilepsy
Corneal Opacity or Poor Visualization
Severe Ocular Inflammation
Relative Contraindications are:
Tanned or Dark Skin
Keloid Tendency
Active Herpes Simplex Infection
Dental Applications
Pacemakers or Implanted Electronic Devices
Uncooperative or Anxious Patients
General Surgery and Oncology
Large Vascular Lesions
Outcomes
PCO treatment restores clear vision for most patients with quick recovery within 24 to 48 hours.
Decreases IOP in angle-closure glaucoma through improved drainage to reduce need for invasive procedures with success rates.
Laser treatment offers 70%-90% hair reduction after multiple sessions. It is most effective on dark or light skin with the Nd wavelength.
Slowly remove tattoo ink through multiple sessions. Dark ink fades best while light colors need more treatments.
It gives quick relief for airway blockages from tumors or strictures in palliative care.
Equipment required
Equipment required:
Nd Laser System
Q-switched Nd and Long-pulsed Nd
Laser Delivery System
Laser Safety Goggles
Patient Preparation:
Both patient and clinician must wear laser safety goggles during skin and dental procedures.
Adjust laser settings based on procedure and patient factors. Use lower settings on dark skin to prevent burns and hyperpigmentation.
Cooling devices used before and after laser pulses for comfort. Minimize discomfort and protect skin with cooling before/after laser.
Patient Positioning:
Ensure patient comfort during procedures. For ophthalmology, position with chin on slit-lamp rest.
For dermatology, patient can be lying or seated depending on treatment area.
Figure. Nd YAG laser device
The laser should be set from 1 to 3 mJ with Q-switched and mode locked.
Q-switched laser produces 12-20 nanosecond single pulses series while a mode-locked laser produces 25-30 picoseconds.
Helium-neon laser is used to focus Nd YAG laser slightly behind lens to prevent damage.
Silicone lenses prone to damage, while polymethylmethacrylate lenses are the most durable choice.
Laser treatment methods vary by surgeon and opacity density. A cross-pattern starting from periphery is recommended by physicians to reduce risk.
Some physicians suggest avoiding circular lasers in favour of firing on stress lines.
Create a 3-mm inverted U-shape capsule to reduce postoperative floaters which keep the flap away from the visual axis.
Various methods for treating lens tilt and Z syndrome with Nd YAG laser involve creating a small oval capsulotomy between the hinge and insertion of hinge loops to relieve tension.
Complications:
Increased Intraocular Pressure (IOP): A sudden rise in IOP may occur immediately after the procedure due to the release of lens capsule debris into the aqueous humor.
Retinal Detachment: A rare but serious complication caused by the shockwaves generated by the laser.
Damage to Intraocular Lens (IOL): Inaccurate laser targeting can cause pits or cracks in the IOL.
Incomplete Iridotomy: It may require re-treatment if the opening in the iris is not sufficient to relieve IOP.
Inflammation/Uveitis: Inflammation of the iris or ciliary body, usually mild and self-limiting with NSAID eye drops.
The Nd YAG (Neodymium-doped Yttrium Aluminum Garnet) laser is a versatile and widely used solid-state laser.
Nd laser was first demonstrated by J.E. Geusic in 1964. Neodymium (Nd) selected for laser ion due to strong energy transitions for high-power lasers.
YAG crystal’s superior thermal properties ideal for continuous and pulsed laser operations.
A crystal of YAG doped with neodymium ions. The doping concentration ranges from 0.5% to 1.4%.
Nd³⁺ ions energized with flash lamps or laser diodes in an optical resonator with two mirrors amplify light through stimulated emission.
Laser beams used for cutting and welding can be pulsed for high peak power in bursts. YAG crystals enable continuous operation.
The Nd YAG laser indicated in various fields including medicine, ophthalmology, dermatology, surgery, and aesthetics.
Posterior Capsulotomy
Peripheral Iridotomy
Vitreolysis
Hair Removal
Pigmented Lesions
Soft Tissue Surgery
Oral Lesion Removal
Tumor Debulking
Absolute Contraindications are:
Active Infection at the Treatment Site
Malignant Lesions
Epilepsy
Corneal Opacity or Poor Visualization
Severe Ocular Inflammation
Relative Contraindications are:
Tanned or Dark Skin
Keloid Tendency
Active Herpes Simplex Infection
Dental Applications
Pacemakers or Implanted Electronic Devices
Uncooperative or Anxious Patients
General Surgery and Oncology
Large Vascular Lesions
PCO treatment restores clear vision for most patients with quick recovery within 24 to 48 hours.
Decreases IOP in angle-closure glaucoma through improved drainage to reduce need for invasive procedures with success rates.
Laser treatment offers 70%-90% hair reduction after multiple sessions. It is most effective on dark or light skin with the Nd wavelength.
Slowly remove tattoo ink through multiple sessions. Dark ink fades best while light colors need more treatments.
It gives quick relief for airway blockages from tumors or strictures in palliative care.
Equipment required:
Nd Laser System
Q-switched Nd and Long-pulsed Nd
Laser Delivery System
Laser Safety Goggles
Patient Preparation:
Both patient and clinician must wear laser safety goggles during skin and dental procedures.
Adjust laser settings based on procedure and patient factors. Use lower settings on dark skin to prevent burns and hyperpigmentation.
Cooling devices used before and after laser pulses for comfort. Minimize discomfort and protect skin with cooling before/after laser.
Patient Positioning:
Ensure patient comfort during procedures. For ophthalmology, position with chin on slit-lamp rest.
For dermatology, patient can be lying or seated depending on treatment area.
Figure. Nd YAG laser device
The laser should be set from 1 to 3 mJ with Q-switched and mode locked.
Q-switched laser produces 12-20 nanosecond single pulses series while a mode-locked laser produces 25-30 picoseconds.
Helium-neon laser is used to focus Nd YAG laser slightly behind lens to prevent damage.
Silicone lenses prone to damage, while polymethylmethacrylate lenses are the most durable choice.
Laser treatment methods vary by surgeon and opacity density. A cross-pattern starting from periphery is recommended by physicians to reduce risk.
Some physicians suggest avoiding circular lasers in favour of firing on stress lines.
Create a 3-mm inverted U-shape capsule to reduce postoperative floaters which keep the flap away from the visual axis.
Various methods for treating lens tilt and Z syndrome with Nd YAG laser involve creating a small oval capsulotomy between the hinge and insertion of hinge loops to relieve tension.
Complications:
Increased Intraocular Pressure (IOP): A sudden rise in IOP may occur immediately after the procedure due to the release of lens capsule debris into the aqueous humor.
Retinal Detachment: A rare but serious complication caused by the shockwaves generated by the laser.
Damage to Intraocular Lens (IOL): Inaccurate laser targeting can cause pits or cracks in the IOL.
Incomplete Iridotomy: It may require re-treatment if the opening in the iris is not sufficient to relieve IOP.
Inflammation/Uveitis: Inflammation of the iris or ciliary body, usually mild and self-limiting with NSAID eye drops.
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