OptoYag&SLT M Ophthalmologists increasingly have to work within th similarly restricted which in some cases limits the a technologies in one device - a Q-switched frequency trabeculoplasty (SLT), and a Q-switched Nd:YAG (106 Selective Laser Trabeculoplasty Although medical therapy and invasive treatments such tube shunts have long been considered the gold stand glaucoma, they are often associated with side effects an which may in turn affect the patient’s quality of life surgeons are turning to safer and less-invasive glaucom SLT. SLT uses a Q-switched frequency-doubled (532 nm) (Nd:YAG) laser which delivers energy in short pulses (4 nm light selectively targets and irradiates melanin c meshwork while preserving the adjacent non-pigmente energy laser irradiation evokes a cytokine respo macrophages, which in turn remove damaged cells. This of the trabecular meshwork which leads to more effectiv thus lowers intraocular pressure (IOP). There is growing evidence to show that SLT is an adjunctive therapy for treating glaucoma. 1 Some estim success rate is between 40% and 70% in adults 2-4 , and th at least comparable to argon laser trabeculoplasty 5 . In medically-treated open-angle glaucoma patients (mean received treatment with Optotek’s SLT technology, IOP w 30% in two thirds of patients. Specifically, at an average (range, 1-14 months), the mean IOP reduction after SLT from a pretreatment IOP of 24.7 ± 4.1 mmHg. 6 An additional benefit of SLT is that it is associated with although surgeons should be aware of potential side effe iritis, corneal haze, hyphema, choroidal effusion, fove edema. 7 Nd:YAG for Capsulotomies and Iridotomies The YAG mode of the OptoYag&SLT M is used to complication associated with cataract surgery - posterio (PCO). It is also used to perform peripheral iridotomies and narrow angle-closure glaucoma. The YAG mode use laser with a wavelength of 1064 nm, and the like the SLT in 4 nanosecond pulses. Although Nd:YAG capsulotomy is efficacious with a goo cause complications such as elevated IOP (transient tears and detachment, cystoid macular oedema, intraoc iritis. Several studies indicate that side effects are m higher single-pulse energy is used; consequently, th OptoYag&SLT M was designed to enable the best treatm energy and fewer shots. M: A Two in One Treatment he confines of restricted healthcare budgets, particularly in the amount of hardware that can be introduced into a practice. Th y-doubled (532 nm) neodymium-doped yttrium aluminium garn 64 nm) laser for capsulotomies and iridotomies. as trabeculectomy and dard in the treatment of nd/or compliance issues e. Consequently, many ma treatments such as neodymium-doped:YAG nanoseconds). The 532 cells in the trabecular ed eye structures. Low- onse which activates s increases the porosity ve aqueous outflow and efficacious primary or mates suggest that the hat the efficacy of SLT is n a study in which 22 n age, 69.4 ± 5.2 years) was reduced by at least e follow-up of 9 months T was 4.5 ± 3.8 mm Hg a low complication rate ects which may include eal burns and macular treat the number one or capsule opacification s in patients with acute es a Q-switched Nd:YAG T mode, delivers energy od safety profile, it may and persistent), retinal cular lens damage, and more pronounced when he YAG mode of the ment results using lower A study that included 53 eyes of 44 patie 89 years]), undertaken at the Univers showed that using Optotek technology, of the therapy or the patient. The fine located just next to the joystick, allow according to the patient’s eye response performed at an energy level of 1.6 m procedures were performed at 1.6 mJ w (range, 27.2 mJ to 320 mJ). The average 17 to 200). 8 OptoYag&SLT M: Key Features/Adva Two-in-One Functionality The SLT mode of the OptoYag&SLT M mJ to 2.6 mJ per pulse. Its red aiming b of the treatment beam, while built-in effective office-based SLT treatment. The YAG mode of the OptoYag&SLT M accuracy and precision of the red aimin Gaussian laser beam profile. Like the SL energy levels, i.e., from 0.5 mJ to 10 excellent photodisruptor capability, whi lower energy and fewer shots. High Performance The OptoYag&SLT M with newly-desig configuration has a repetition rate of 3 sessions, which not only improves pr patient comfort. Figure 1: The O Solution EU. Additionally, clinic space is often he OptoYag&SLT M provides two key net (Nd:YAG) laser for selective laser ents (mean age, 76.49 years; [range, 59 to sity Medical Centre Ljubljana, Slovenia, , Nd:YAG laser match the specific needs energy setting buttons are conveniently wing the physician to adapt the energy e - capsulotomies could be successfully mJ. Indeed, the authors reported that all with an average total energy of 104.72 mJ e number of pulses used was 65.5 (range, ntages offers 33 energy levels ranging from 0.2 beam (650 nm) allowing precise focusing safety features ensure quick, safe and provides optimized focusing optics, high ng beam system, and a clean and stable LT mode, the YAG mode offers a range of mJ per pulse, in 30 steps. It also has ich enables best treatment results using gned laser cavity and optimized system Hz. This allows faster, shorter treatment ractice productivity, but also increases OptoYag&SLT M
Transcript
OptoYag&SLT M: A Two in One Treatment Solution
Ophthalmologists increasingly have to work within the confines of restricted healthcare budgets, particularly in the EU. Addi
similarly restricted which in some cases limits the amount of hardware that can be introduced into a practice.
technologies in one device - a Q-switched frequency
trabeculoplasty (SLT), and a Q-switched Nd:YAG (1064 nm) laser
Selective Laser Trabeculoplasty
Although medical therapy and invasive treatments such as trabeculectomy and
tube shunts have long been considered the gold standard in the treatment of
glaucoma, they are often associated with side effects and/or compliance issues
which may in turn affect the patient’s quality of life. Consequently, many
surgeons are turning to safer and less-invasive glaucoma treatments such as
SLT.
SLT uses a Q-switched frequency-doubled (532 nm)
(Nd:YAG) laser which delivers energy in short pulses (4 nanoseconds). The 532
nm light selectively targets and irradiates melanin cells in the trabecular
meshwork while preserving the adjacent non-pigmented eye structures. Low
energy laser irradiation evokes a cytokine response which activates
macrophages, which in turn remove damaged cells. This increases the porosity
of the trabecular meshwork which leads to more effective aqueous outflow and
thus lowers intraocular pressure (IOP).
There is growing evidence to show that SLT is an efficacious primary or
adjunctive therapy for treating glaucoma.1 Some estimates suggest that the
success rate is between 40% and 70% in adults2-4, and that the efficacy of SLT is
at least comparable to argon laser trabeculoplasty5. In a study in which 22
30% in two thirds of patients. Specifically, at an average follow-up of 9 months
14 months), the mean IOP reduction after SLT was 4.5 ± 3.8 mm Hg
associated with a low complication rate
ential side effects which may include
hyphema, choroidal effusion, foveal burns and macular
The YAG mode of the OptoYag&SLT M is used to treat the number one
posterior capsule opacification
It is also used to perform peripheral iridotomies in patients with acute
The YAG mode uses a Q-switched Nd:YAG
ith a wavelength of 1064 nm, and the like the SLT mode, delivers energy
Nd:YAG capsulotomy is efficacious with a good safety profile, it may
cause complications such as elevated IOP (transient and persistent), retinal
rs and detachment, cystoid macular oedema, intraocular lens damage, and
iritis. Several studies indicate that side effects are more pronounced when
pulse energy is used; consequently, the YAG mode of the
he best treatment results using lower
A study that included 53 eyes of 44 patients (mean age, 76.49 years; [range, 59 to
89 years]), undertaken at the University Medical Centre Ljubljana, Slovenia,
showed that using Optotek technology, Nd:YAG laser match the specific needs
of the therapy or the patient. The fine energy setting buttons are conveniently
located just next to the joystick, allowing the physician to adapt the energy
according to the patient’s eye response
performed at an energy level of 1.6 mJ.
procedures were performed at 1.6 mJ with an average total energy of 104.72 mJ
(range, 27.2 mJ to 320 mJ). The average number of pulses used was 65.5 (range,
17 to 200).8
OptoYag&SLT M: Key Features/Advantages
Two-in-One Functionality
The SLT mode of the OptoYag&SLT M
mJ to 2.6 mJ per pulse. Its red aiming beam (650 nm) allowing precise focusing
of the treatment beam, while built-in safety features ensure quick, safe and
effective office-based SLT treatment.
The YAG mode of the OptoYag&SLT M provides optimized focusing optics, high
accuracy and precision of the red aiming beam system, and a clean and stable
Gaussian laser beam profile. Like the SLT mode, the YAG mode offers a ran
energy levels, i.e., from 0.5 mJ to 10 mJ per pulse, in 30 steps. It also has
excellent photodisruptor capability, which enables best treatment results using
lower energy and fewer shots.
High Performance
The OptoYag&SLT M with newly-designed laser
configuration has a repetition rate of 3 Hz. This allows faster, shorter treatment
sessions, which not only improves practice productivity, but also increases
patient comfort.
Figure 1: The OptoYag&SLT M
OptoYag&SLT M: A Two in One Treatment Solution
Ophthalmologists increasingly have to work within the confines of restricted healthcare budgets, particularly in the EU. Additionally, clinic space is often
The OptoYag&SLT M provides two key
yttrium aluminium garnet (Nd:YAG) laser for selective laser
A study that included 53 eyes of 44 patients (mean age, 76.49 years; [range, 59 to
89 years]), undertaken at the University Medical Centre Ljubljana, Slovenia,
showed that using Optotek technology, Nd:YAG laser match the specific needs
e patient. The fine energy setting buttons are conveniently
located just next to the joystick, allowing the physician to adapt the energy
according to the patient’s eye response - capsulotomies could be successfully
performed at an energy level of 1.6 mJ. Indeed, the authors reported that all
procedures were performed at 1.6 mJ with an average total energy of 104.72 mJ
(range, 27.2 mJ to 320 mJ). The average number of pulses used was 65.5 (range,
OptoYag&SLT M: Key Features/Advantages
offers 33 energy levels ranging from 0.2
mJ to 2.6 mJ per pulse. Its red aiming beam (650 nm) allowing precise focusing
in safety features ensure quick, safe and
The YAG mode of the OptoYag&SLT M provides optimized focusing optics, high
accuracy and precision of the red aiming beam system, and a clean and stable
Gaussian laser beam profile. Like the SLT mode, the YAG mode offers a range of
energy levels, i.e., from 0.5 mJ to 10 mJ per pulse, in 30 steps. It also has
excellent photodisruptor capability, which enables best treatment results using
designed laser cavity and optimized system
configuration has a repetition rate of 3 Hz. This allows faster, shorter treatment
sessions, which not only improves practice productivity, but also increases
The OptoYag&SLT M
High Power LED Illumination System
The device incorporates an e-SlitLight™ LED slit lamp which offers thousands of
hours of bright white light originating from the solid state LED light source. The
LED illumination enhances color, detail and contrast and therefore
improves imaging. Additionally, its minimal heat emission makes the treatment
comfortable even for patients with dry eye.
Fine Energy Setting
Advanced technical solutions and sophisticated electronics incorporated into
the OptoYag&SLT M allow for a precise adjustment of energy in order to match
the specific needs of the therapy or the patient. The fine energy setting buttons
are conveniently located just next to the joystick, allowing the physician to adapt
the energy according to the patient’s eye response - easily and accurately.
Pulse to Pulse Stability
The OptoYag&SLT M also incorporates pulse to pulse stability (PPS™)
technology for delivering stable energy that far exceeds current industry
standards. Enhancing the accuracy and stability of energy delivery assures the
highest levels of safety while facilitating effective and efficient eye treatments.
Figure 2: PPS Technology versus Conventional Laser Technology
Portable and Easy to Use
The OptoYag&SLT M is supplied in a convenient portable design that allows the
operator to change location with ease. The electronics box is housed underneath
the table, which means the system can be moved freely to another worktop and
is therefore always ready to use. Moreover, the table height is ful
which is particularly beneficial when treating wheelchair-
The device was designed with ease of use in mind. The fine energy setting
buttons are located next to the joystick, thus enabling the physician to adapt
energy according to clinical needs, while maintaining continuous control
throughout the treatment process.
Mechanical Precision
Most companies that provide YAG/SLT devices hand the production over to third
party manufacturers. In contrast, the OptoYag&SLT is des
constructed in-house. Although Optotek often works in collaboration with
suppliers within the EU, the company has the technological expertise to produce
high quality optical and mechanical components in-house, which allows them to
set the highest standards possible.
SlitLight™ LED slit lamp which offers thousands of
hours of bright white light originating from the solid state LED light source. The
LED illumination enhances color, detail and contrast and therefore significantly
improves imaging. Additionally, its minimal heat emission makes the treatment
Advanced technical solutions and sophisticated electronics incorporated into
w for a precise adjustment of energy in order to match
the specific needs of the therapy or the patient. The fine energy setting buttons
are conveniently located just next to the joystick, allowing the physician to adapt
easily and accurately.
The OptoYag&SLT M also incorporates pulse to pulse stability (PPS™)
technology for delivering stable energy that far exceeds current industry
y of energy delivery assures the
highest levels of safety while facilitating effective and efficient eye treatments.
PPS Technology versus Conventional Laser Technology
portable design that allows the
operator to change location with ease. The electronics box is housed underneath
the table, which means the system can be moved freely to another worktop and
Moreover, the table height is fully adjustable,
-bound patients.
The device was designed with ease of use in mind. The fine energy setting
buttons are located next to the joystick, thus enabling the physician to adapt
according to clinical needs, while maintaining continuous control
Most companies that provide YAG/SLT devices hand the production over to third
party manufacturers. In contrast, the OptoYag&SLT is designed, developed and
house. Although Optotek often works in collaboration with
suppliers within the EU, the company has the technological expertise to produce
house, which allows them to
Expert Opinion
"The OptoYag&SLT M is a true dual use device with no compromises or
weaknesses to either mode. I found the optics to be superb and the adjustable
table could even suit wheelchair bound patients. Most
mode makes peripheral iridotomy and capsulotomy procedures very easy,
efficient and safe".
Dan Lindfield, BM, FRCOphth, Consultant Ophthalmologist (Glaucoma)
Surrey County Hospital, UK.
Summary
The OptoYag&SLT M is a two-in-one device that allows surgeons to perform SLT,
peripheral iridotomies and capsulotomies with the same instrument. The device
incorporates several unique features including PPS and a
illumination system. The OptoYag&SLT M represents a
for both the glaucoma specialist and the general ophthalmologist.
References
1. De Keyser M, De Belder M, De Belder S,
does selective laser trabeculoplasty stand now? A
Eye Vis (Lond). 2016;3:10.
2. Shibata M, Sugiyama T, Ishida O, et al. Clinical results of selective laser
trabeculoplasty in open angle glaucoma in Japanese eyes: comparison of 180
degree with 360 degree SLT. J Glauc. 2012;21(1):17
3. Tang M, Fu Y, Fu MS, et al. The efficacy of
trabeculoplasty. Ophthalmic Surg Lasers Imaging.
4. Song J, Lee PP, Epstein DL, et al. High failure rate of 180 degree selective
laser trabeculoplasty. J Glaucoma. 2005;14(5):400
5. Juzych MS, Chopra V, Banitt MR, et al. Comparison of long
selective laser trabeculoplasty versus argon laser trabeculoplasty in open
glaucoma. Ophthalmology.2004;111(10):1853
6. Cvenkel B, Grčar R. Selective laser trabeculoplasty in treatment of open
glaucoma. Journal of the Laser and Health Academy Vol. 2013, No.1;
www.laserandhealth.com.
7. Song J. Complications of selective laser trabeculoplasty: a review.
Ophthalmology (Auckland, NZ). 2016;10:137
8. Hawlina G, Drnovšek-Olup B. Nd:YAG laser capsulotomy for treating posterior
capsule opacification. Journal of the Laser and Health Academy
S35.
is a true dual use device with no compromises or
weaknesses to either mode. I found the optics to be superb and the adjustable
table could even suit wheelchair bound patients. Most importantly, the YAG
mode makes peripheral iridotomy and capsulotomy procedures very easy,
Consultant Ophthalmologist (Glaucoma) at Royal
one device that allows surgeons to perform SLT,
peripheral iridotomies and capsulotomies with the same instrument. The device
incorporates several unique features including PPS and a high power LED
OptoYag&SLT M represents an ideal treatment solution
for both the glaucoma specialist and the general ophthalmologist.
De Belder S, De Groot V. Where
stand now? A review.
Shibata M, Sugiyama T, Ishida O, et al. Clinical results of selective laser
trabeculoplasty in open angle glaucoma in Japanese eyes: comparison of 180
2012;21(1):17–21.
Tang M, Fu Y, Fu MS, et al. The efficacy of low-energy selective laser
Ophthalmic Surg Lasers Imaging. 2001;42(1):59–63.
Song J, Lee PP, Epstein DL, et al. High failure rate of 180 degree selective
2005;14(5):400–408.
itt MR, et al. Comparison of long-term outcomes of
selective laser trabeculoplasty versus argon laser trabeculoplasty in open-angle
(10):1853–185.
čar R. Selective laser trabeculoplasty in treatment of open-angle
glaucoma. Journal of the Laser and Health Academy Vol. 2013, No.1;
Song J. Complications of selective laser trabeculoplasty: a review. Clinical
. 2016;10:137-143.
Olup B. Nd:YAG laser capsulotomy for treating posterior
Journal of the Laser and Health Academy 2013 (1): S34-
