Medical tourism - a new concept of world healthcare

Medical tourism - a new concept of world healthcare

MILITARY MEDICAL ACADEMY

LASERS IN OPHTHALMOSURGERY: THEORETICAL AND PRACTICAL BASIS

The purpose of the manual is to help ophthalmologists systematize knowledge in the basic aspects of laser biology and medicine in order to effectively use laser technologies in clinical practice.

Intended for ophthalmologists, clinical residents, and specialists associated with laser medicine.

The author expresses his gratitude to professors V. Volkov and M. Shishkin for reviewing the manual.

© Boyko E., 2003 © VMedA, 2003

Ophthalmology is the specialty that has made the most of all the advances in laser technology since the introduction of the first lasers in 1960. As a result, the emergence and introduction into clinical practice of a significant number of new treatment methods, highly effective in the hands of specially trained ophthalmologists. The expansion of the practical possibilities of laser ophthalmosurgery is facilitated by the creation of new, portable, convenient and affordable laser devices that can be successfully used in many polyclinics and hospitals. However, sometimes the lack of information among doctors with such a variety of methods of laser interventions and new technical equipment hinders the introduction of modern methods of treatment. Under these conditions, a deep study of the fundamentals of laser exposure is the only way not to get lost in the world of new laser devices and techniques. This manual is intended to systematize the basic concepts of laser surgery as applied to ophthalmology. The manual is intended for ophthalmologists, clinical residents and will be useful to everyone interested in laser medicine.

A brief historical background

The use of light radiation for the non-contact and non-invasive delivery of energy to the structures of the eye has opened a new era in the history of ophthalmic surgery. Thanks to the enthusiasm and pioneering work of G. Meyer-Schvickerath, as well as other scientists, the study of the possibilities of using light (first - solar, then from electric sources and xenon lamps) began in the forties and fifties of the last century. As a result of these works, the advantages of light surgery over traditional ones became obvious, and the effect of photocoagulation of eye tissues was introduced into clinical practice. In the development and creation of the first optical quantum generators - lasers - the work of Russian scientists N. Basov and A. Prokhorov, as well as the American researcher C. Townes, for which these scientists were awarded the Nobel Prize in 1964. In 1960, the first laser was created, and thanks to this, a revolution took place in optics and other fields of science: sources of controlled intense coherent radiation appeared, which made it possible to concentrate high energy in very small spectral, spatial and temporal ranges.

It is not surprising that as soon as the first lasers appeared, their biological effect was studied in an experiment, and then the therapeutic possibilities were applied in the clinic. Mediums transparent for visible light: cornea, lens, vitreous body made it possible to non-invasively deliver radiation of this range to the tissues of the fundus and coagulate them. Obviously, therefore, the fundus laser coagulation technique was developed first (Campbell C.., Zweng H. et al., 1963) and still remains one of the most common in ophthalmology. The next significant step forward was the clinical use of the photo-rupture effect for the destruction of secondary cataracts and for basal iridectomy in glaucoma in the seventies of the XX century (M. Krasnov). A lot has been done in the field of laser ophthalmosurgery thanks to the long-term cooperation of the Department of Ophthalmology of the Military Medical Academy and the State Optical Institute named after V.I. FROM. . Vavilova (V. Volkov, V. Zhokhov, L. Balashevich, Yu. Berezin, A. Gatsu, E. Boyko). The first domestic coagulators for the outer parts of the eye, its inner membranes, for ophthalmic oncology, endolaser dissectors for vitreoretinal surgery were developed, created and comprehensively studied in experiment and clinic.

After the discovery of the effect of ablative photodecomposition using ultraviolet lasers (Srinivasan, 1982), an intensive experimental and then clinical study of this effect began. Recently, excimer lasers have made it possible to qualitatively change the approach to refractive surgery of the cornea (S. Fedorov, A. Semenov).

Currently, it is difficult to even count the number of laser methods used to treat eye diseases, and their number is constantly growing. A very brief historical background indicates that the development of therapeutic techniques is based on the use of certain biological effects "laser radiation-biological tissue", which must always be taken into account in practical work. The chronology of the introduction of the effects "laser radiation-biological tissue" into clinical practice is shown in Fig. 1.

Today, medical tourism is one of the most popular types of tourism. Patients from all over the world travel abroad for treatment, combining quality medical care with pleasant relaxation. The leaders in providing high quality medicine are.

Today, medical tourism is one of the most popular types of tourism. Patients from all over the world travel abroad for treatment, combining quality medical care with pleasant relaxation. Countries such as Germany, Switzerland, Austria, Israel, USA and Canada are leaders in the provision of high quality medicine.

Types of medical tourism

According to the goals a patient sets for himself when going abroad for treatment, medical tourism is divided into three main categories:

  • Wellness - wellness tours, detox and spa treatments to improve well-being and increase immunity.
  • Diagnostic - examination of a patient using laboratory and instrumental methods for making an accurate diagnosis and assessing the characteristics of the clinical course of the disease.
  • Curative - therapy and rehabilitation.

The world is becoming closer and closer, and the borders between states are becoming more open. The number of people traveling to another country to receive medical services is increasing every year.

Medical tourism in figures:

  • 85% of patients are referred for treatment because they want to receive better medical care
  • 27% of medical tourists have already undergone treatment abroad at least once
  • 36% of patients use the services of companies organizing treatment abroad
  • On average, a medical tourist spends 7-14 thousand dollars per trip
  • 45-65 years - age, in which people most often travel abroad for treatment
  • 30 million people a year are treated or recovered outside their home country

Medical tourism goals

Countries that receive the most tourists from around the world have one or more of the following benefits:

  • Availability of special climatic conditions (curative mud, thermal springs, etc.)
  • Possibility of performing operations or medical manipulations at low prices
  • The ability to provide high-tech medical care not available in other states

Among the main reasons for the popularity of medical tourism is the use of the latest technologies that are often not available in domestic hospitals. Among them:

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