recent progress in medical laser technologies ____________________________

48
Recent Progress Recent Progress in in Medical Laser Technologies Medical Laser Technologies ____________________________ ____________________________ 醫 醫 醫 醫 醫 醫 醫 醫 醫 醫 醫 醫 醫 醫 醫 醫 醫 醫 醫 醫 醫 醫 3-2008 3-2008 J.T. Lin, Ph.D J.T. Lin, Ph.D Chairman Chairman New Vision, Inc. New Vision, Inc. 醫醫醫醫 醫醫醫醫 ( 醫醫醫醫醫醫醫 醫醫醫醫醫醫醫 ) ( ) ( 醫醫醫醫 醫醫醫醫 ) ) 醫醫醫 醫醫醫 ( 醫醫醫 醫醫醫 ) ) 醫醫醫醫醫醫醫醫 醫醫醫醫醫醫醫醫 ( 醫醫 醫醫 ) 醫醫 醫醫 ( ( 醫醫醫醫 醫醫醫醫 ) 醫醫醫醫醫醫 醫醫醫醫醫醫 ( 醫醫 醫醫 )

Upload: hoai

Post on 10-Feb-2016

43 views

Category:

Documents


2 download

DESCRIPTION

Recent Progress in Medical Laser Technologies ____________________________. 醫 療 雷 射 技 術 之 最 新 進 展. J.T. Lin, Ph.D Chairman New Vision, Inc. 交通大學 ( 光電工程研究所 ) ( 客座教授 ) 工研院 ( 南分院 ) 雷射應用科技中心 ( 顧問 ) 鴻海 ( 精密工業 ) 股份有限公司 ( 顧問 ). 3-2008. Definitions. LASER L ight - PowerPoint PPT Presentation

TRANSCRIPT

Page 1: Recent Progress  in Medical Laser Technologies ____________________________

Recent Progress Recent Progress inin

Medical Laser TechnologiesMedical Laser Technologies________________________________________________________

醫 療 雷 射 醫 療 雷 射 技 術技 術 之 最 新 進 展 之 最 新 進 展

3-20083-2008

J.T. Lin, Ph.D J.T. Lin, Ph.D ChairmanChairman

New Vision, Inc.New Vision, Inc.

交通大學交通大學 (( 光電工程研究所光電工程研究所 ) () ( 客座教授客座教授 )) 工研院工研院 (( 南分院南分院 ) ) 雷射應用科技中心 雷射應用科技中心 (( 顧顧問問 ))鴻海 鴻海 (( 精密工業精密工業 )) 股份有限公司 股份有限公司 (( 顧問顧問 ))

Page 2: Recent Progress  in Medical Laser Technologies ____________________________

DefinitionsDefinitions LASER LASER LLight ight AAmplification by mplification by SStimulated timulated EEmission ofmission of RRadiation (adiation ( 激光激光 )) ---------------------------------------------------------------------------------------------------------------------------------------------------------------- 雷射 雷射 (( 音譯音譯 ) vs ) vs 激光激光 (( 意譯意譯 ) )

--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

光子光子 (Photon) vs. (Photon) vs. 光波光波 (Wave) (Wave) ----------------------------------------------- ----------------------------------------------- Diode vs. LEDDiode vs. LED (laser) …………. (light)(laser) …………. (light)

Page 3: Recent Progress  in Medical Laser Technologies ____________________________

Historical Historical 1900 (1900 (Max PlanckMax Planck) …quantum mechanics) …quantum mechanics 1917 (1917 (EinsteinEinstein) …… A & B Coefficients) …… A & B Coefficients 1954 (Townes)…... MASER (microwave)1954 (Townes)…... MASER (microwave) 1960 (Maiman)…… Ruby laser1960 (Maiman)…… Ruby laser 1961 (Javan, Johnson) ……. HeNe, Nd:YAG1961 (Javan, Johnson) ……. HeNe, Nd:YAG 1962 (Bennett)…….. Argon laser1962 (Bennett)…….. Argon laser 1964 (Patel) ………. CO2 laser1964 (Patel) ………. CO2 laser The laser-patent war /Gordon Gould (1997). The laser-patent war /Gordon Gould (1997). 眼科眼科應用應用 1983….. (UV-193 on organic tissue 1983….. (UV-193 on organic tissue IBM PatentIBM Patent, ), ) 1990 …. PRK (vision correction, 1990 …. PRK (vision correction, VisX patentVisX patent)) 1992 …. LASIK 1992 …. LASIK (Scanning)(Scanning) ( Lin’s patent) ( Lin’s patent) 1998 …. Presbyopia-I1998 …. Presbyopia-I (Lin’s patent)(Lin’s patent) 2008 …. Presbyopia-II , 3um didoe-laser (Lin)2008 …. Presbyopia-II , 3um didoe-laser (Lin)

Page 4: Recent Progress  in Medical Laser Technologies ____________________________

Overall Laser Overall Laser ApplicationsApplications 食食 ,, 衣衣 ,, 住住 ,, 行行 ,, 育樂育樂

國防國防 ,, 醫療、醫療、 資訊與通訊、資訊與通訊、 科技研發、 科技研發、 交通交通 ,, 工程施工工程施工 ,, 品管、品管、 藝術活動、文物維護、藝術活動、文物維護、 環境監測、環境監測、

Page 5: Recent Progress  in Medical Laser Technologies ____________________________

(1) (1) 低發散性 低發散性 (low divergence) (low divergence) 用於工程、環境、軍事、生物體等的遙測用於工程、環境、軍事、生物體等的遙測 , , 光纖通訊、光纖導航儀、光束武器、精密加工 等。光纖通訊、光纖導航儀、光束武器、精密加工 等。 (2) (2) 高強度 高強度 (high intensity): (high intensity): 光熱、光動力、光化光熱、光動力、光化學等作用學等作用 focused spot size (micron ~ focused spot size (micron ~ 0.001 mm)0.001 mm)(3) Pure-spectrum (narrow band-(3) Pure-spectrum (narrow band-width): width): spectroscope, chemistry..spectroscope, chemistry..

(4) Tunable spectrum (via non-linear (4) Tunable spectrum (via non-linear processes)processes) 非線性光學非線性光學 , , 調變波長調變波長 , , 脈寬脈寬 (pulse width) (pulse width)

(5) (5) 高相干性 高相干性 (high Coherence)(high Coherence) 用於藉干涉效應反映物質狀態及分佈、產生全像記錄用於藉干涉效應反映物質狀態及分佈、產生全像記錄 應用於檢驗、資料的高密度存取、藝術、防仿冒標籤等應用於檢驗、資料的高密度存取、藝術、防仿冒標籤等

SPECIAL Features of LASER:SPECIAL Features of LASER:

Page 6: Recent Progress  in Medical Laser Technologies ____________________________

Non-medical applicationsNon-medical applications MilitaryMilitary 國防國防 - laser range-finder (1064, 1554 nm)- laser range-finder (1064, 1554 nm) - laser beam-weapon (STAR War)- laser beam-weapon (STAR War)

Car industry:Car industry:

- speeding, counter-speeding- speeding, counter-speeding - collision-free - collision-free - auto-parking- auto-parking - overhead screen, GPS- overhead screen, GPS - - auto-drivenauto-driven

Page 7: Recent Progress  in Medical Laser Technologies ____________________________

Bio-medical Bio-Medical Photonics

Energy beams: Laser, LED, RF, non-coherent- light, Ultrasound

Optical materials

Fibers & beam delivery

Optical diagnosis, spectroscope

Electronic

System integration

Software & hardware

Bio-imaging, Bio-sensor

Photo-therapy (PDT) Photo-biology

Surgical, coagulation

Drug delivery, tracking, characterization

Nano-medicine, bio-materials, bio-chem

Tissue Engineering/welding

Bionic human (artificial organs) NVI

Photon + Electronics Biology + MedicineBiology + Medicine 光 電 光 電 + + 生 醫 生 醫

Page 8: Recent Progress  in Medical Laser Technologies ____________________________

to be an Innovator to be an Innovator (( 創 新 者 )

Rumsfield (2006)

Know knownUn-know knownUn-know un-known Know un-known

Innovation VS.

Improving

NVI

Page 9: Recent Progress  in Medical Laser Technologies ____________________________

先 知 先 覺 ( Pioneer ) VS. 後 知 後 覺 ( Follower ) 創 新 者 (innovator)

知 人 所 不 知 也 ! Know un-known“物理” = 萬物之理也

Page 10: Recent Progress  in Medical Laser Technologies ____________________________

工研院工研院 (( 南分院南分院 ) ) 雷射應用科技中雷射應用科技中心 心 ITRI ProjectsITRI Projects 前瞻性前瞻性 (( 原創性原創性 )) 新產品新產品 (1) (1) 高階高階 (( 二類及三類產品二類及三類產品 ) ) - - 新雷射光源及光纖瓶頸技術之突破 新雷射光源及光纖瓶頸技術之突破 - - 臨床批准高門檻臨床批准高門檻 (2) (2) 新技術新技術 ,, 新材料新材料 ,, 新手術新手術 (( 關鍵性之專利關鍵性之專利 ) ) (3) (3) 國內外皆尚未商品化 國內外皆尚未商品化 (4) (4) 可於 可於 2 ~ 3 2 ~ 3 年內產生跳躍式產業創新及年內產生跳躍式產業創新及 自有品牌新產品 自有品牌新產品 .. (5) (5) 牙科牙科 ,, 眼科眼科 ,, 耳科耳科 ,, 美容皮膚科及顯微手術之應美容皮膚科及顯微手術之應

用用 ..

Page 11: Recent Progress  in Medical Laser Technologies ____________________________

Examples of innovation-IMPACTExamples of innovation-IMPACT Only < 1% patents has major financial impacts !!!Only < 1% patents has major financial impacts !!! (the METHODS patents)(the METHODS patents) IBM (1983 US patent):IBM (1983 US patent): UV laser (193 nm, ArF) for all organic tissue ablationUV laser (193 nm, ArF) for all organic tissue ablation licensed to LaserSight for >$30Mlicensed to LaserSight for >$30M Steve Troke (Columbia Univ.)Steve Troke (Columbia Univ.) 1986 US Pat…ArF for PRK/LASIK1986 US Pat…ArF for PRK/LASIK value : >$2.0 Bvalue : >$2.0 B JT Lin (1991, 2000, 2004, 2006 US pat)JT Lin (1991, 2000, 2004, 2006 US pat) scanning-laser for Lasikscanning-laser for Lasik value > $500Mvalue > $500M Shue Lai (1993)Shue Lai (1993) eye-tracking device, eye-tracking device, value >$200Mvalue >$200M

JT Lin (1998)..JT Lin (1998).. laser for presbyopia laser for presbyopia value > $200M (???)value > $200M (???)

Page 12: Recent Progress  in Medical Laser Technologies ____________________________

Medical products Medical products developmentdevelopment

Idea, concept, theory

Lab test, R&D

Clinical (Animal, human) (in Vitro, in Vivo)

System Integration &Commercialization

Search, re-searchDefining parameters

Proto-type (1-2 years)

Phase-I (Safety)Phase-II (Efficacy)Phase-III (Commercial)

(1-8 years) FDA approval (510-K or PMA)(patents, improving)

Lin-7-2007 NVI

Page 13: Recent Progress  in Medical Laser Technologies ____________________________

Bio-Physics Bio-Physics Laser-tissue Laser-tissue interaction interaction

Mechanisms:Mechanisms: (Absorption, reflection, scattering) (Absorption, reflection, scattering) 1) Thermal 1) Thermal 2) non-thermal2) non-thermal 3) combined effects3) combined effects (Coagulation-ablation, cutting-incision)(Coagulation-ablation, cutting-incision)

Key parameters:Key parameters: Wavelength, Pulse width (Tp), Wavelength, Pulse width (Tp), Energy (E), Intensity (I), Power (P), fluency (F)Energy (E), Intensity (I), Power (P), fluency (F) Absorption coefficient (A), Reflection/scattering loss Absorption coefficient (A), Reflection/scattering loss

concept: F = E/ laser spot-sizeconcept: F = E/ laser spot-size I= E/ pulse-widthI= E/ pulse-width

Page 14: Recent Progress  in Medical Laser Technologies ____________________________

Thermal vs. Non-Thermal vs. Non-thermal thermal

(1) Thermal: ( most cosmetic lasers): (1) Thermal: ( most cosmetic lasers):

low-power, low intensity, long-pulselow-power, low intensity, long-pulse weak-absorption (A) , weak-absorption (A) , CW visible lasers, LED (400-700 nm)CW visible lasers, LED (400-700 nm) Diode (1.3-2.2 um)Diode (1.3-2.2 um) Ho:YAG (2.1 um), CO/2(10.6 um)Ho:YAG (2.1 um), CO/2(10.6 um)

(2) Non-thermal (Lasik, kidney-stone, dental/hard-tissue)(2) Non-thermal (Lasik, kidney-stone, dental/hard-tissue)

Short-pulse, high peak-power, Short-pulse, high peak-power, Strong absorption (A>100 cm-1)Strong absorption (A>100 cm-1) (in water, tissue, melanin, protein , etc)(in water, tissue, melanin, protein , etc)

short-pulsed short-pulsed (ps - fs) laser (independent to wavelength)(ps - fs) laser (independent to wavelength) Er:YAG (2.94 um), Excimer-laser (193, 248 , 308 nm)Er:YAG (2.94 um), Excimer-laser (193, 248 , 308 nm)

Page 15: Recent Progress  in Medical Laser Technologies ____________________________

Absorption (blood, Absorption (blood, skin)skin)

wavelength (um)

melanin HbO2

420

580

A

0.2 0.5 1.0 1.2

Page 16: Recent Progress  in Medical Laser Technologies ____________________________

Absorption in Absorption in Water/TissueWater/Tissue

0 1.0 2.0 3.0 10 (microns) 0 1.0 2.0 3.0 10 (microns)

Absorption (A)Absorption (A)

1.451.45

1.931.93

2.942.94

CO2-laserCO2-laser

Page 17: Recent Progress  in Medical Laser Technologies ____________________________

Penetration-depth(d=1/A) vs. wavelength

UV VISIBLE Near-IR Mid-IR

(0.2-0.4) (04.-0.7) (0.8- 2.1) (2.7-3.2) um

(0.05-0.5) mm (0.5-2.0)

(2.0-6.0)

(0.2-0.5) 0.05 mm

Water 3 absorption peaks: 1.45, 1.93, 2.94 um

Page 18: Recent Progress  in Medical Laser Technologies ____________________________

Laser Ablation Theory Laser Ablation Theory (1) (1) Beers law:Beers law: I(z) = I(0) Exp [-Az]I(z) = I(0) Exp [-Az]

(2) (2) Ablation depth (Ablation depth (H) is given byH) is given by H = (1/A) ln (F/F*)H = (1/A) ln (F/F*) where F*= threshold laser fluence where F*= threshold laser fluence for ablation to occur. for ablation to occur. optimal A* given by dH/dA = 0optimal A* given by dH/dA = 0 A*=2.718 (F*/F)A*=2.718 (F*/F)

(3) (3) Lin’s lawLin’s law (2005, for focused laser) (2005, for focused laser) I = B I(0) Exp(-Az)I = B I(0) Exp(-Az)

B=focusing factor for optimal depth.B=focusing factor for optimal depth.

0 F* 0 F* F F

Depth (H)Depth (H)

0 A* 0 A* A A

Depth (H)Depth (H)

Page 19: Recent Progress  in Medical Laser Technologies ____________________________

Laser heating theoryLaser heating theory Laser produced tissue temperature via heat conduction Laser produced tissue temperature via heat conduction

equationequation dT/dz = k (ddT/dz = k (d22 T/dz T/dz22)) where k=temperature conductivitywhere k=temperature conductivity Laplace transform or the Green function method to Laplace transform or the Green function method to

obtainobtain T(z,t) = Integrate { S G dz dt }T(z,t) = Integrate { S G dz dt } S is the heat source and G is the Green function S is the heat source and G is the Green function

given by given by G = C exp [ -(z-z0)^2 / 4k(t – t0) ]G = C exp [ -(z-z0)^2 / 4k(t – t0) ] Thermal penetration depthThermal penetration depth d* = square root of (4kt) d* = square root of (4kt) = 0.75 = 0.75 square root [laser pulse width]square root [laser pulse width] for d (in um)m and t (in usec).for d (in um)m and t (in usec). Example: Example: for 1 usec laser, the heat conduction distance is about for 1 usec laser, the heat conduction distance is about

0.75 um.0.75 um.

The one-micron ruleThe one-micron rule: ( t*=1.0 usec): ( t*=1.0 usec) short pulsed laser for non-thermal process.short pulsed laser for non-thermal process. example: fiber laser (f.s.)example: fiber laser (f.s.)

timetime

Temp.Temp.

Page 20: Recent Progress  in Medical Laser Technologies ____________________________

System design consideration

1. Hemoglobin (blood) 2. Melanei (skin-color) 3. Water (Tissue) 4. Others (protein etc)

(2) Hard tissue (bones, teeth)

shock-wave plasma-assisted

Wrinkle-removalWrinkle-removal Hair-removalHair-removalPDTPDT

Non-invasiveNon-invasive(invasive)(invasive)

(1) For soft-tissue(1) For soft-tissue

Page 21: Recent Progress  in Medical Laser Technologies ____________________________

Major medical proceduresMajor medical procedures

1.1. 眼科 眼科 2. 2. 美容及皮膚科美容及皮膚科 3. 3. 泌尿科泌尿科 4. 4. 口腔科口腔科, , 五官科五官科 5. 5. 婦科婦科

Page 22: Recent Progress  in Medical Laser Technologies ____________________________

泌尿科 泌尿科 (Prostate)(Prostate) Technology: endoscope + laser + fiberTechnology: endoscope + laser + fiber

Laserscope, Inc. (acq. by AMS for $1.9 B)Laserscope, Inc. (acq. by AMS for $1.9 B) high-power (50-80 W)high-power (50-80 W) cw, green (532 nm) lasercw, green (532 nm) laser fiber-coupledfiber-coupled ** side firing** side firing Other lasers: Other lasers: Er:YAG (2.9 um) Ho:YAG(2.1 um), Er:YAG (2.9 um) Ho:YAG(2.1 um),

Th:YAG(2.07 um)Th:YAG(2.07 um) diode-laser (1.4 – 2.9 um)diode-laser (1.4 – 2.9 um)

45-angle45-angle

Page 23: Recent Progress  in Medical Laser Technologies ____________________________

Dental lasersDental lasers(1) Hard tissue (dentin, carries)(1) Hard tissue (dentin, carries) a) Biolase “water-laser” (Er:YSGG at a) Biolase “water-laser” (Er:YSGG at

2.78 um)2.78 um) b) Lin/ITRI, mid-IR diode laser (2.7-3.0 b) Lin/ITRI, mid-IR diode laser (2.7-3.0

um)um)(2) Diode laser (soft tissue)(2) Diode laser (soft tissue) at 808, 940, 980 nmat 808, 940, 980 nm(3) Teeth whitening(3) Teeth whitening Nd:YAG (1064) + dyeNd:YAG (1064) + dye(4) Velcope (4) Velcope Blue-light (or LED) to detect cancer tissueBlue-light (or LED) to detect cancer tissue

Page 24: Recent Progress  in Medical Laser Technologies ____________________________

Photodynamic therapy Photodynamic therapy (PDT)(PDT)

Laser-activated process Laser-activated process a). Photo-sensitizers a). Photo-sensitizers Red-dye, ALA… red-laser (630-660 nm),Red-dye, ALA… red-laser (630-660 nm),

IR-dye, HPPH, … IR-laser (750 - 1200 nm)IR-dye, HPPH, … IR-laser (750 - 1200 nm) b) UV-laser excitation .. visible-laser fluorecenseb) UV-laser excitation .. visible-laser fluorecense

c). Nano-particle c). Nano-particle ..(ITRI-2008)..(ITRI-2008) 780-850 nm ps-laser780-850 nm ps-laser,,

ApplicationsApplications: : Cancer, tumor , antibody detection,Cancer, tumor , antibody detection, Psoriasis, acne, Psoriasis, acne,

Age-related macular degeneration (AMD)Age-related macular degeneration (AMD) hair-growthhair-growth, wound-healing etc.., wound-healing etc..

Page 25: Recent Progress  in Medical Laser Technologies ____________________________

Optical Biopsy Optical Biopsy ((breast cancerbreast cancer detection)detection)

Prof. Alfano at CCNYProf. Alfano at CCNY SPIE (2006, #6091)SPIE (2006, #6091) breast cancerbreast cancer detection: detection: UV (282, 300 nm) as UV (282, 300 nm) as

excitation,excitation, compare fluorescence compare fluorescence

spectra spectra of normal and cancerous of normal and cancerous

tissuetissue Ratio:Ratio: I/345 : I /500 = 3 to 5 timesI/345 : I /500 = 3 to 5 times

UV UV 345 nm345 nm

500 nm500 nm

cancercancer

Page 26: Recent Progress  in Medical Laser Technologies ____________________________

Ultra-short-pulsed (USP) Ultra-short-pulsed (USP) LasersLasers

USP laser (tp< 20 p.s.)…USP laser (tp< 20 p.s.)…non-thermal non-thermal Applications:Applications: (1) high speed spectroscopy(1) high speed spectroscopy (2) 3-photon cancer diagnosis (2) 3-photon cancer diagnosis (1.2 um, third-harmonic)(1.2 um, third-harmonic) (3) corneal-flap for Lasik (Nd:YAG, 1064 nm)(3) corneal-flap for Lasik (Nd:YAG, 1064 nm) (4) materials process(4) materials process fiber-laser at 1030-1550 nmfiber-laser at 1030-1550 nm - Raydiance, Inc.(USA)- Raydiance, Inc.(USA) - - ITRI(ITRI( 工研院工研院 ,, 南分院南分院 )) for medical, industrial uses.for medical, industrial uses.

Page 27: Recent Progress  in Medical Laser Technologies ____________________________

Cosmetic Applications Cosmetic Applications 1). 1). Hair removalHair removal Diode lasers (808, 940, 1064 nm)Diode lasers (808, 940, 1064 nm) Alexandrite laser (at 760 nm, pulsed)Alexandrite laser (at 760 nm, pulsed) (damage of follicle, hair-root ..)(damage of follicle, hair-root ..) Hair-growth:Hair-growth: red LED (630-680 nm) red LED (630-680 nm)

2). Skin Rejuvenation2). Skin Rejuvenation Invasive (Er:YAG, CO2), Invasive (Er:YAG, CO2), Non-invasive (1.32, 1.55 um)Non-invasive (1.32, 1.55 um) LED (880,630,580,420 nm)LED (880,630,580,420 nm) 3). lesions 3). lesions AcneAcne (blue-LED/420 nm, IR fiber-laser/1550 nm) (blue-LED/420 nm, IR fiber-laser/1550 nm) tatoo (ruby, N:YAG), tatoo (ruby, N:YAG), spots (co2, Er:YAG, alex, dye laser) spots (co2, Er:YAG, alex, dye laser) 4). 4). PsoriasisPsoriasis (excimer-308, red-LED/630) (excimer-308, red-LED/630)

* non-laser methods:* non-laser methods: Radio-Frequency (MHz), Radio-Frequency (MHz), microwave , UVA (--B) light microwave , UVA (--B) light pulsed-light (broad band, 400-1200 nm)pulsed-light (broad band, 400-1200 nm)

Page 28: Recent Progress  in Medical Laser Technologies ____________________________

Laser hair removalLaser hair removal

1. dermis

2. epi-dermis

3. sebacecusglands

4. follicle

5. root

6. Papilla

7. Blood vessel

hair

(1)(2)

(3)(4)

(5)(6)

(7)

Skin-hair structure

Page 29: Recent Progress  in Medical Laser Technologies ____________________________

(1)Wrinkle removal (2) pigmented lesion(3) vascular lesions(4) acne

(5) leg veins (6) tatoo

Page 30: Recent Progress  in Medical Laser Technologies ____________________________

Home use hand-held LEDHome use hand-held LED4- color LEDs : IR (940 nm)Yellow (580 nm)Red (660 nm)Blue (470 nm)

Page 31: Recent Progress  in Medical Laser Technologies ____________________________

Hair growthHair growth

Laser-comb

Red-LED (630-695 nm)

Page 32: Recent Progress  in Medical Laser Technologies ____________________________

發展趨勢發展趨勢 :Combining-:Combining-energyenergy

(( 聯合療法聯合療法 ) ) Laser + LED + RF + Laser + LED + RF + Intense-Pulsed-light (IPL)Intense-Pulsed-light (IPL) 美白雷射、美白雷射、 去黑雷射、去黑雷射、 退紅雷射、退紅雷射、 脈衝光脈衝光 (1) 鉺雷射 (Er: YAG),

(2) IR-diode laser (1.34,1.54,1.9, 2.8 um) (3) fiber-laser (FRACTOR)

Page 33: Recent Progress  in Medical Laser Technologies ____________________________

““Smart eye” designsSmart eye” designs (learned from nature’s evolution theory )(learned from nature’s evolution theory )

On the origin of species by means of On the origin of species by means of Natural Selection Natural Selection (Charles Darwin,1859) (Charles Darwin,1859)

““Functional adaptation” is one of the important Functional adaptation” is one of the important built -in survival mechanisms built -in survival mechanisms of all species.of all species.

Analysis of smart eyes with high power lens-accommodation Analysis of smart eyes with high power lens-accommodation (Lin, JCRS, 2007, 35, 758-759)(Lin, JCRS, 2007, 35, 758-759)

Examples: Examples: Diving birds, sharks, octopus, StingraysDiving birds, sharks, octopus, Stingrays

Page 34: Recent Progress  in Medical Laser Technologies ____________________________

Low-field myopia theroyLow-field myopia theroy

Pupil height (cm)

LFM (diopter)

0

-10

-200 10 100

1 (Frog)

3 (Pigeon)

5(horse)

2 (Stingray)

4 (Crane)

1. Frog (1994)

2. Stingray (1942)

3. Pigeon (1942) 4. Crane

5. Horse (1975)

V (cm)

Near vision distance V = -100/ D (cm)

5

10

20

7

腿短动物必定近视 腿短动物必定近视 ??

Page 35: Recent Progress  in Medical Laser Technologies ____________________________

Stingray Stingray non-spherical non-spherical eye-structureeye-structure

(to see both far & near)(to see both far & near)

See near D= - 1000 H/ Sinθ (long axis)

See far

Y

y

Retina surface

LENS

Opticalaxis

Object

Sinθ =H/VH

X'

V

θ

* * Lin (2005, unpublished)Lin (2005, unpublished)

Page 36: Recent Progress  in Medical Laser Technologies ____________________________

Scan-195 LASIK System (developed by JT Lin, 1995)

Page 37: Recent Progress  in Medical Laser Technologies ____________________________

LASIK vs. PRKLASIK vs. PRK LASIK (stroma) PRK (surface) 2 steps 1-step + microkeratom

Page 38: Recent Progress  in Medical Laser Technologies ____________________________

Flying-spot scanning Flying-spot scanning system*system*

CORNEACORNEA

193 193 nmnm

Eye-trackingEye-tracking

* * Lin (US Patent, 1992)Lin (US Patent, 1992)

Advantages of Scanning LASIK:Advantages of Scanning LASIK:

1)1) Smooth surfaceSmooth surface2)2) Smaller energy/pulse ( 1 vs. 36 mJ)Smaller energy/pulse ( 1 vs. 36 mJ)3)3) Customized ablation for Customized ablation for super-vision (< 20/10)super-vision (< 20/10)

EXCIMER (ArF)EXCIMER (ArF)

SCANNERSCANNER

Page 39: Recent Progress  in Medical Laser Technologies ____________________________

Non-linear processNon-linear process Harmonic generationHarmonic generation

1064 >> 532 >>355 >>213 nm (KTP, LBO, BBO)1064 >> 532 >>355 >>213 nm (KTP, LBO, BBO) 5-th harmonic (213 nm) for LASIK 5-th harmonic (213 nm) for LASIK (Lin, 1992 US patent)(Lin, 1992 US patent)

Optical Parametric Oscillation Optical Parametric Oscillation (OPO) (OPO) for tunable lasers (0.6 -3.2 um)for tunable lasers (0.6 -3.2 um) 1064 >> (1.5 to 3.2 um) ... KTP 1064 >> (1.5 to 3.2 um) ... KTP (Lin & Montgomery, 1989)(Lin & Montgomery, 1989)

355 >> (0.6 to 1.3 um) .... BBO355 >> (0.6 to 1.3 um) .... BBO

Raman shift (SRS, SBS)Raman shift (SRS, SBS) (in methane, H2, D2 gas)(in methane, H2, D2 gas) 1064 (in CH4)>> 1.54 um (eye-safe range finder/Litton)1064 (in CH4)>> 1.54 um (eye-safe range finder/Litton) 532 (in H2) >> 460(Stokes), 682 (anti-stokes)532 (in H2) >> 460(Stokes), 682 (anti-stokes)

Page 40: Recent Progress  in Medical Laser Technologies ____________________________

Diode-pumped solid-Diode-pumped solid-state LASIKstate LASIK

Nd:YAG

1064 532 532 266 213

UV-213 100Hz 5 mJOverall eff. 12%

KTP(II) BBO(I) BBO(II)

LBO(I)KDT(I)

1064 1064

Diode-pumped100Hz, 40mJ10 ns

*UV-213 for LASIK (Lin, US patent, 1992)

Page 41: Recent Progress  in Medical Laser Technologies ____________________________

全球独一产品

New Vision, Inc.(2008)

PR-270 激光 老视 - 治疗仪 Laser for Presbyopia

True accommodation安全 , 不伤角膜 ( 优于LASIK)可一次做双眼 ( 优于 CK限单眼 )

UV-laser

林氏动力二元论 (JT Lin, JRS, 2005)J.T. Lin 2001 年欧洲白内障与屈光手术会议 (ESCRS)提出 LPT 巩膜切除术后总调节度 (accommodation amplitude ) A= LR+AS, LR= 晶狀体变形 (lens relaxation) AS= 晶狀体前移 (anterior shift), AS=(1.0-1.5) D/mm

for patientsfor patients age: 45-68age: 45-68

Page 42: Recent Progress  in Medical Laser Technologies ____________________________

SCIENCE (September 29, 2006)SCIENCE (September 29, 2006)

Page 43: Recent Progress  in Medical Laser Technologies ____________________________

The Bionic-humanThe Bionic-human(2/2002, Science)(2/2002, Science)

Page 44: Recent Progress  in Medical Laser Technologies ____________________________

Bionic TechnologiesBionic Technologies 1. Robotic hand1. Robotic hand 2. Tissue repairing2. Tissue repairing 3. Artificial organs3. Artificial organs (heart, liver, blood)(heart, liver, blood) 4. Bionic-eye4. Bionic-eye Combined efforts of:Combined efforts of: bio-engineers, cell-biologists, bio-engineers, cell-biologists,

cliniciansclinicians

Page 45: Recent Progress  in Medical Laser Technologies ____________________________

Bionic-eyeBionic-eyeRetina-simulationRetina-simulation

Micro-chip

(3x3x1 mm)

Page 46: Recent Progress  in Medical Laser Technologies ____________________________

New Directions (The next 3-5 years trends)New Directions (The next 3-5 years trends) - - IInnovative concepts for newnnovative concepts for new methods & methods & treatments treatments - - - -

- LED for l- LED for lowow--cost light source cost light source ((replacing lasersreplacing lasers)).. - D- Diode lasers iode lasers in Mid-IR (2- 3 microns),in Mid-IR (2- 3 microns), replacing Ho, Er:YAGreplacing Ho, Er:YAG - Ultra-short pulsed (fiber) lasers- Ultra-short pulsed (fiber) lasers - Combined energy-beam:- Combined energy-beam: LASER, LASER, IPL, LEDIPL, LED, , RFRF

- N- New optical fibers ew optical fibers (materials & structures)(materials & structures) - Real-time image monitoring (endoscope)- Real-time image monitoring (endoscope) - - More efficient, selective image detection devicesMore efficient, selective image detection devices in optical biopsyin optical biopsy - L- Lessess--toxic agentstoxic agents,, such as nanoparticles and new such as nanoparticles and new IR dyesIR dyes,, in PDT procedures. in PDT procedures.

Page 47: Recent Progress  in Medical Laser Technologies ____________________________

More New DirectionsMore New Directions- - - SSolidolid--state UV laser state UV laser , , replacing the toxic excimer laser replacing the toxic excimer laser - for LASIK.for LASIK.- - Femto-second lasers for - Femto-second lasers for - PDT, cancer diagnosis,PDT, cancer diagnosis,- and blade-less LASIKand blade-less LASIK

- M- Multiple wavelength, multi-applications systemsultiple wavelength, multi-applications systems - M- Minimally invasive techniques for class II or II procedures.inimally invasive techniques for class II or II procedures.

REFERENCESREFERENCES 1. 1. J.T. Lin, Laser Applications in Ophthalmology, Jaypee J.T. Lin, Laser Applications in Ophthalmology, Jaypee

Brothers (2008), Brothers (2008), 2 2 J.T. Lin, US Patent J.T. Lin, US Patent NNo. 5144630o. 5144630 (1992).(1992). 3. 3. 久保于市久保于市 ,Medical Applications of Lasers Tokyo, Japan page ,Medical Applications of Lasers Tokyo, Japan page

186 (1985). 186 (1985).

Page 48: Recent Progress  in Medical Laser Technologies ____________________________

ConclusionConclusion(1) (1) 醫療雷射之發展趨勢醫療雷射之發展趨勢 :: 眼科眼科 , , 美容及皮膚美容及皮膚科科 泌尿科泌尿科 , , 口腔科 口腔科 五官科五官科 , , 妇科妇科 ((type II, III)…type II, III)…market-drivenmarket-driven

(2) (2) 光光 ,, 機機 .. 電電 ,, 生醫生醫‧‧整合技術整合技術 光電、奈米、資訊、電機、電子、光電、奈米、資訊、電機、電子、 影像、光纖 等影像、光纖 等 (3) (3) 產、學、臨床產、學、臨床 ,, 合作合作Thank you for your attention Thank you for your attention !!!!