The Founding of Hong Kong Surgical Laser Association

There is an untold story behind how Hong Kong Surgical Laser Association was formed. When we discovered HKSLA’s members, council members and even the president held a vague concept towards HKSLA’s history and start-up practices, we were determined to record down everything so HKSLA’s history will not be forgotten by its members. By passing on HKSLA’s mission through each generation, we hope more people will learn about HKSLA’s history.

The start of HKSLA began in an Ophthalmological Society meeting in 1990, where Dr. Ho Chi Ping, the President back then, mentioned an ENT doctor, Dr. Andrew Van Hasselt from the Chinese University of Hong Kong. He wanted to form a laser association that promotes laser technology in the medical field. I suggested that ophthalmologists should take more initiative in forming such a laser association as ophthalmologists were the first Specialty of doctors who used laser in the medical practice. With everyone’s agreement, an organising committee was formed. The members included five doctors: Dr. Ho Chi Ping, Dr Liu Kai Ching (the Senior Consultant in-charge of all government ophthalmologists in Hong Kong back then) and me. The other two doctors are Dr. Watt Chung Yin (veteran surgeon at Queen Elizabeth Hospital), and Dr. Lo Kwok Hung (veteran surgeon at Princess Margaret Hospital Hong Kong). The first official meeting of the committee took place at the Hong Kong Chinese Civil Servant Association on Wylie Road. Dr. Ho Chi Ping was the chairman of the committee while I was the secretary.

The term “laser” originated as an acronym for “light amplification by stimulated emission of radiation” so the common Chinese translation is “激光”. We were faced with two options in registering for a name: Hong Kong Laser Association or Hong Kong Medical Laser Association. Upon arrival, the registry informed us that both names were not available. After tracking down the company with the name, they offered it to us in return for some ten thousand dollars. But we felt it unworthy, so we changed our name to Hong Kong Surgical Laser Association. For the Chinese name, as we could not use “激光”, we chose the name “香港鐳射醫學會”. “鐳射” is an alternative translation of Laser. If we never told this story, who will know? This is how HKSLA earned its name. After a year of preparation, HKSLA was officially set up in 1991 with Dr. Ho Chi Ping as the President and me as Honorary Secretary. There were 190 HKSLA members back then.

We founded HKSLA based on a few important objectives: First we aim to promote laser technology in the medical field. This includes therapeutic theories, technological researches, functions, applications and safety measures, and how patients can benefit through this technology. So we united veteran doctors together who held a great interest in laser technology and had rich clinical experience background. This fostered an interflow of ideas and exchange of expertise to further develop laser application in the medical field. The second objective is to protect the public’s safety. There are many non-medical practitioners who operate lasers, raising our concerns towards whether their level of knowledge and techniques can safeguard the public’s safety. We do not want to witness anyone sustaining harmful effects after being treated with laser. Thirdly we want to educate the general public about laser technology. This will branch out into two methods; the first is to educate consumers to think more logically and become “smart” consumers. If the public is more knowledgeable towards this, they will be able to identify the suitable medical practitioners who are qualified practitioners to operate under a mutual safety agreement. On the contrary, we may need to enforce laws to protect the public’s right and safety if the public’s awareness is low. This can minimize usage of laser technology by unqualified personnel. The second way is to educate doctors, medical practitioners, nurses and other users of laser technology on how to operate this technology safely, and ensuring they are qualified. We can avoid enforcing laws if users of this technology are qualified to use laser technology.

In terms of achievements, HKSLA have accomplished a lot over the past years and organized numerous local conferences and some with Mainland doctors. We highly encourage our members to participate in local and overseas conferences. So we set up the Dr. TKC LIU Scholarship to sponsor different members every year to attend international conferences. Members will be required to share what they have learnt after returning from a conference. TKC LIU Scholarship is established in memory of the early departed Dr. Timothy K.C. Liu who was one of HKSLA’s founders and very well respected ophthalmologist. He was my teacher when I first entered government ophthalmic service, providing me with support and guidance all along.

In addition, we have publications on the usage of laser technology distributed freely to medical practitioners and the general public. We also have two guideline booklets. The first one was launched in 1994 in partnership with The Hong Kong Medical Association to reflect credibility and authority. The guideline is separated into two sections; the first section is a basic introduction to laser technology. The second section comprises of more in-depth information, it is separated into different specialties including application of laser technology to ophthalmology, dentistry, surgery, otolaryngology and other specialties. In 2004, ten years after the first guideline publication, we decided it was time for a revisal. As laser technology continued to develop over the years, there are more laser devices and more diseases cured with it, so after three years of preparation we launched the second guideline in 2007. I was the editor in-chief. Comparing the first and second guideline publications, the second uses A4 instead of the previous B5, and is richer in content. The former was published in English while the second is bilingual in English and Chinese. We especially invited doctors from the Chinese Medical Association to translate our publication to Chinese, allowing more medical practitioners and the public to benefit from information about laser technology. Time flies, another 10 years have passed so we are in the process of another new publication.

Looking forward, HKSLA’s future objective remains the same as the present one: safeguarding the public’s safety which includes the safety application of laser technology, the devices used and methods applied. The medical field had just started to apply light therapy when HKSLA was founded; it has developed into various forms of light therapy including phototherapy and therapies using other forms of different radio-frequencies and high energy focused ultrasound. Besides doctors, there are other people who perform laser therapy for the public; we are deeply concerned with their standards of safety measures. We are not suggesting they are 100% unsafe, but they should provide evidence to the general public and the government that their usage of laser technology is safe, which requires a scale to measure.
HKSLA holds an important standpoint towards the application of laser technology, which is endorsed by The Hong Kong Medical Association. Lasers are classified according to the degree of light energy and the corresponding harm it can cause. Class 1 laser is the least hazardous class and is considered to be incapable of producing damaging levels of laser emission such as a laser pointer or laser scanner in a supermarket. Class 4 lasers present significant eye, skin and fire hazards. Our standing point is: Class 3B or above lasers when deliver to human body should only be operated by registered medical and dental practitioners whether the laser technology is performed for investigation, therapeutic or aesthetic purposes.

Of course, there are always challenges up ahead. We have proposed to the government in putting more focus towards laser treatment for a long time. There are patients with permanent scars produced by laser attributed to the mishandling of laser usage. The government never responded to the request until the last director of the Department of Health Dr. Lam Ping-yan proposed to manage all medical devices by categories. This includes laser, ultrasound and scalpels to contact lens. There were four main categories at the beginning. With the first category belonging to ones that produce the least harm to the human body like medical cotton, flashlights etc, to the ones that can easily harm the human body like scalpel and laser. The present director Dr, Chan Hon-yee will precede with this. We are looking forward to the outcome from it. At the same time, we also hope that the government can offer more effective methods in protecting the general public. It is unnecessary to enforce laws if there is a high level of public awareness towards laser technology. If not, it calls for the government’s action in ensuring a healthy medical development and safe medical environment for the general public.

Twenty years ago, only few people used laser technology besides medical practitioners. At that time, the government did not enforce any laws to regulate this industry. Anyone with money can buy a laser machine to be used anywhere. Currently, the application of laser technology is widely used in a variety of industries, take the beauty treatment industry for example, there are around one hundred thousand people using it. The real big challenge is setting the standard for operating laser technology. If the standard is strict, will it cost the jobs of one hundred thousand people? If the requirements are low, then it cannot safeguard the public’s safety. Decision on a standard is becoming harder, the longer we delay the harder. We already missed the perfect chance so we need to seize our last chance.

HKSLA will seize opportunities by being dependent on different levels of education and law enforcements in working closely with both the government and merchants. The government will promote education and enforce laws, while the merchants will run business in respect of the right work ethics. We will also focus on research and studies in combining theories and practical practices. In providing cross-disciplinary opportunities for doctors and scholars, they will participate in the improvement and development of laser technology, inventing better and safer new devices and raising the public’s awareness towards laser technology.

HKSLA’s membership is open to all medical and dental practitioners registered in the Hong Kong SAR, offering members the chances to participate in conferences in China, locally and internationally. Members have the right to apply for the TKC LIU Scholarship and study materials. Once you become a member, you pledge to protect HKSLA’s reputation, and it is a members’ responsibility to avoid any actions that can affect HKSLA’s reputation.

Dr. Chow Pak Chin