Laser upgrade launched

San Mateo, CA-Topcon Medical Laser Systems Inc. has launched a system upgrade for its family of lasers (PASCAL, Streamline, and Streamline 577) offering scanning technology and tissue-sparing sub-threshold treatment options.

The upgrade (Endpoint Management) includes Landmark treatment options, which are used to give reference marks for sub-threshold treatment and enhance surgeon control.

The upgrade refines the surgeon's titration ability through fine gradation of laser output, providing precise management in setting visible or nonvisible target endpoints on the retina.

Titration to a barely visible endpoint is first done to establish a baseline, said Mark Wieland, MD, clinical voluntary associate professor, Stanford University, Palo Alto, CA, who has recently begun using the system in his San Mateo, CA, retina practice.

After titration is set, the Landmark option is used to mark the pattern boundaries. The energy levels are controlled by the algorithms, which the physician can set to levels that do not produce visible lesions.

Imaging techniques such as optical coherence tomography and fluorescein angiography have been used to demonstrate the effects of the sub-visible laser treatments.

"The strategy is to apply a sub-visible treatment within therapeutic boundaries," Dr. Wieland said. "The desired clinical outcome would be a therapeutic response without damage to the photoreceptors. This sub-visible treatment may be effective for macular edema."

While some peripheral vision loss is associated with all conventional panretinal photocoagulation treatment, this may be minimized with Endpoint Management and preservation of the peripheral neural retina, Dr. Wieland explained.

"This upgrade provides an intuitive, reliable means to deliver sub-threshold treatments to the retina," he said. "The option to set recognizable burns in the pattern periphery aids in feedback for laser dose and reference to the treated area."

He added that the ultimate goal is to accomplish the therapeutic objective with minimal collateral damage to the retina and optimal patient comfort and convenience.

FYI

Mark Wieland, MD
Phone: 650/340-0111
E-mail: rva.mwieland@gmail.com

Dr. Wieland is a consultant for Topcon PASCAL