History, evolution of lasers in ophthalmology

New Orleans-Calling it an “innovator’s dilemma,” Mark S. Blumenkranz, MD, reflected on the extreme difficulties inventors often face in the beginning of a technological advance.

“The many costs are borne by few,” said Dr. Blumenkranz, as he delivered the Jackson Memorial Lecture during the AAO Opening Session.

This dilemma is a problem-often seen in the introduction and disruption of new technology-and lasers have been no different, he noted.

The first medical application of the laser-which occurred less than a year after its invention-was retinal photocoagulation. Since then, its effect on ophthalmology cannot be overestimated, as lasers have become abound in all ophthalmic specialties for both diagnostic and therapeutic devices, said Dr. Blumenkranz, the H.J. Smead professor and chairman of ophthalmology, Stanford University School of Medicine, Stanford, CA.

He noted that he sees the future of emerging laser technologies not just through an inventor's and practitioner’s eyes, but also through economic eyes.

He has questions, Dr. Blumenkranz said, like many, of payment.

“Current dilemmas and controversies surrounding the role of government in the provision and payment of health care in a cobbled-care world” make it difficult to answer, he said. “I do believe payment is an important question and will need to be answered by us and others as we evaluate the introduction of continuing new generations of laser technologies, medical devices, and drug technologies in the future.”

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