THE HEART OF THE MATTER
a special program of the National Emergency Medicine Association (NEMA) 

Week: 502.5 Guest: Sheri Rowen, M.D., F.A.C.S. Topic: Lasers and Eye Surgery- Part One Host: Richard Roeder Producer: Ed Graham

NEMA: This is a conversation with ophthalmologist Dr. Sheri Rowen from the Katzen Eye Group in Baltimore, Maryland on her use of lasers for eye and cosmetic surgery.

NEMA: Dr. Rowen, one of the real innovations in eye surgery has been the use of the laser. Would you begin our discussion with a little technical background on what a laser is and how it works in a surgical environment.

ROWEN: Okay. A laser in a surgical environment is high-frequency light and it's powered by different elements that are excited and then they cause the light energy to be delivered in a very accurate form where you can direct it with exactly the power and size that you need.

NEMA: So you're basically using a laser in surgical environments as a knife?

ROWEN: You can use it as a knife. You can use it as something to seal off vessels. You can use it to reshape skin. So there's lots of things that it can be used for.

NEMA: So in conventional eye surgery or modern eye surgery on the actual eye itself, what are some of the ways that you are using lasers?

ROWEN: Some of the early lasers we used for retinal procedures, for diabetics with leaky blood vessels and new blood vessels. We could treat right inside the eye with that. We can also use the laser to open up the capsule as I said after cataract surgery and so to restore someone's sight in that manner. The newest laser that I've become involved with that I'm very excited about is a carbon dioxide laser. It's called the ultra-pulse and it acts in two ways. One, it can create an incision like you just mentioned and with that incision we can remove extra skin and we can remove fat. So we can take the saggy skin on the top of the lid and the puffy bags under the bottom of the lid out with the laser. The next part of the laser that's recently been added to it is the ultra-pulse portion and what that does is then it resurfaces the outer layer of the skin. It thermally evaporates the outer skin cells and helps the collagen underneath to reform in a more regular pattern and a tighter pattern so that the skin reforms without wrinkles. It loses its memory for the old wrinkles that it had from aging so we can get rid of the wrinkles and tighten up the skin with this new laser.