Steady growth in medical laser technology can be largely traced to two sources: innovation in the field and popular demand for procedures involving laser treatment. Lasers are generally becoming smaller, more precise and easier to use, to the benefit of both the medical field and the aging population alike.

For nearly half a century, designers and manufacturers have coupled the laser's space-age appeal with practical, real world utility. The result can be seen in a heatless beam carving micrometer-sized holes in a hypodermic needle, or an ultraviolet laser recalibrating a patient's cornea to improve his vision.

"The laser is already considered a state-of-the-art production tool in the medical device industry," Dr. Alexander Knitsch, production manager of Trumpf Laser Company, told Medical Design Technology magazine in April. Existing lasers can perform microwelding on devices as sensitive as pacemakers or neural implants.

But, Knitsch adds, "The future design of medical devices demands not only smaller dimensions, but also new applications in the field of micro-processing."

Recent applications, such as those for the ultrashort pulse laser (USP), reflect the current drive to pioneer new tools and methods.

Whether developing lasers to replace older equipment or to perform previously impractical techniques, engineers and manufacturers are seeing plenty of action surrounding the technology. But while the technology continues to advance, producing smaller and more efficient versions of existing laser equipment, how will designers and manufacturers react to subsequent changes in medical user needs?

Consumer Demand
Corrective eye surgery is one of today's most popular laser treatments, and it greatly contributes to consumer interest in medical lasers. The Associated Press reports that nearly 700,000 Americans undergo the LASIK procedure each year.

Laser scalpels are also gaining widespread use as an alternative to traditional cutting implements. "This technology fits in very nicely with the idea of doing minimally invasive surgery that is maximally effective," Dr. Anand Devaiah, of Boston Medical Center, told Mass High Tech.

Used in vision correction surgery, as well as other laser-based treatments, laser scalpels provide a clean, precise incision with limited physical contact.

Globally, laser treatments (particularly cosmetic surgery) are on the rise, making it all the more important to understand the fundamentals of laser technology in the medical field.

Medical Lasers and How They Work
A laser is essentially an energy emission focused tightly on a small area. A stream of photons emerges from the laser, forming a beam whose wavelength (in medical applications) ranges from the ultraviolet to the infrared spectrum. The laser's pulse rate, power density, and energy distribution can all affect how it interacts with a given material. (For a more detailed explanation, see Medical Device & Diagnostic Industry magazine's Laser Basics: Interactions with Materials.)

Some of the more common types of lasers found in medical applications include the following:

• Nd:YAG: These lasers use a crystal to emit infrared waves and high-intensity pulses. They can be found not only in manufacturing processes such as etching and engraving, but also in cosmetic surgery, eye surgery and dentistry.

• CO²-Powered: Frequently used for industrial cutting and welding, carbon dioxide lasers emit a gas discharge that is used as a laser medium, and are effective in procedures involving biological tissue, such as dermabrasion and skin resurfacing.

• Excimer: These are ultraviolet lasers employing a combination of reactive gases to generate a highly precise beam. In addition to semiconductor production, they are commonly used in eye surgery or other delicate operations.

"The functionality of surfaces by systematic laser structuring offers new possibilities in medical technology," said Dr. Knitsch. "Further applications are being developed." It seems that standard applications are being further broadened, and that laser innovation will remain a continuous process.

Growth in the Marketplace
According to the latest annual survey by Laser Focus World, the market for non-diode medical lasers "gained 11 percent in 2007 to reach $495 million and will grow another 11 percent in 2008."

Overall growth has been propelled largely by increases in cosmetic laser treatments. Laser wrinkle removal and skin resurfacing have gained strongly in popularity, and, says Laser Focus World, "it appears the hair-removal market is nowhere near the point of saturation."

The government has also taken note of the expanded range of medical laser treatment, enlisting the Oregon Medical Laser Center for participation in an $85 million research grant. The project will focus on using lasers to treat acute swelling in wounded veterans returning from abroad.

Safety and Consumer Needs
Alongside technological and marketplace growth, there is also rising concern for safety in laser treatments. With safety a top priority across all industry sectors today, medical equipment purchasers and patients are increasingly aware of the risks associated with rapid innovation in the field. The issue could refocus attention to training on the technology, to manufacturers designing and producing equipment that is easier to operate and to regulatory oversight.

"Sadly, there are many people who are laser techs who have done very little, maybe a weekend course, maybe some other training. We believe that you require more information than that," Dr. Alastair Carruthers, president of the American Society for Dermatologic Surgery, told CNN.com.

Since Congress passed a law overhauling device regulations in 2002, the U.S. Food and Drug Administration is reviewing and clearing applications from medical device makers more quickly, according to an agency report released yesterday (via Reuters).

Proliferation of laser treatments and the rapid advancements in laser technology are beginning to elevate public scrutiny, and it remains to be seen how manufacturers will react to these changing demands.

Resources

Perspectives on Miniaturization (Part II)
Medical Design Technology, April 2008

FDA Advisers: Clearer LASIK Warnings Needed
The Associated Press, April 25, 2008

ASCRS to Participate in and Co-Fund Study on Post-LASIK Quality of Life with U.S. Food and Drug Administration
ACRS.org, April 7, 2008

OmniGuide Nears VC Round, Plans Global Expansion
by Ryan McBride
Mass High Tech, April 28, 2008

Laser Basics: Interactions with Materials
by Girish Kelkar
Medical Device & Diagnostic Industry, March 2007

Laser Marketplace 2008
by Kathy Kincade and Stephen G. Anderson
Laser Focus World, January 2008

Oregon Medical Laser Center Shares Grant to Treat Soldiers
Portland Business Journal, April 17, 2008

Laser Surgery in Wrong Hands Can Be Dangerous
by Ronni Berke
CNN.com, Sept. 21, 2007

US FDA says medical device review times improving
Reuters, June 23, 2008