The LightLas DeuxTM is an ophthalmic laser that provides two lasers in the one system:
- An SLT laser to enable the doctor to treat open-angle glaucoma with Selective Laser Trabeculoplasty (SLT), and,
- A Photodisruptor for posterior capsulotomy and iridotomy.
This flexibility has been achieved by the packaging of two laser systems in the one instrument.
The SLT laser is a frequency-doubled Nd:YAG producing pulsed 532nm light. The photodisruptor laser is an Nd:YAG producing 1064 nm. The appropriate treatment modality is conveniently selected by the physician, whilst the treatment by both lasers is channelled through the same delivery system that can be further used as a quality examination slit lamp.
SLT uses short pulses of low energy 532 nm light to target and enrich melanin-rich cells in the trabecular meshwork. The laser pulses affect only the melanin-rich cells, and the surrounding structure of the trabecular meshwork is unaffected. The result is that the body uses microphages to clear the affected cells and to rebuild the meshwork so that it again functions effectively, thus reducing intraocular pressure (IOP).
The SLT technique is far less traumatic than the Argon Laser Trabeculoplasty (ALT), which is still the most widely used laser treatment for elevated IOP. ALT does not prevent the open-angle glaucoma from recurring, and re-treatment is often required. Unfortunately the photocoagulative effects of ALT treatment leaves permanent scarring to the trabecular meshwork that prohibits such re- treatment.
SLT retains the therapeutic benefit of laser treatment without the collateral damage to non-melanin containing cells and to the trabecular meshwork structure. It has been shown that SLT is as effective as ALT in lowering IOP, and has the additional benefit of enabling re-treatment if required. SLT has also been successfully used on patients who have already undergone ALT without the expected results.
The LightLas YAG has been designed with doctor and patient accessibility and comfort in mind. The new slim line design, outboard chinrest and maximum travel stand accommodates patients from the smallest to the tallest with equal ease. Even the largest patients can reach the chinrest without discomfort. For the physician, the LightLas YAG features dual handed controls, a large working distance between the objective and the patients' eye whilst a small working distance from the binocular eye pieces to the patient, drastically reducing the strain on the back when operating.
|Laser Type||Crystal Q-switched Nd: YAG||Q-switched, frequency doubled YAG|
|Energy Range||0.2 to 15mJ, in single pulse continuously variable (<50mJ max. in triple pulse)||0.2-2.6mJ per pulse, continuously variable in 0.1 increments|
|Burst Mode||1, 2, or 3 pulses per shot, selectable||Single Pulse|
|Mode Structure||Fundamental, diffraction limited||Frequency-doubled, diffraction limited|
|Avg. Air Breakdown||2.1 mJ||N/A|
|Spot Size||8 µm||400 µm|
|Cone Angle||16° degrees||< 3 degrees|
|Treatment Beam Offset Range||±500 µm, continuously variable||10 mm, fixed|
|Laser Repitition Rate||Up to 3.0Hz||Less than or equal to 2.5Hz|
|Aiming Beam||Dual Beam laser diode, continuous wave, Red 635 nm||Single Beam Red Diode, continuously variable adjustable intensity|
|Laser Delivery||Galilean Slit Lamp integrated, stereoscopic 16x microscope with converging optics|
|Magnification||Integrated 5‐position: 6x, 10x, 16x, 25x, 40x|
|Safety Filter||Fixed, OD5 @ 1064 nm|
|Cooling||Air convection, passive|
|Power Requirements||100‐240 VAC, 50/60 Hz, Auto ranging|
|Power Rating||500 VA|
|Dimensions||72cm x 54cm x 54cm (LxWxH)
28" x 21" x 21" (LxWxH)
|Weight||21Kg / 46.3 lb (system)
30Kg / 65 lb (packaged)
DUAL FUNCTION LASER SYSTEM
The LightLas DeuxTM is a dual-function SLT and photodisruptor laser designed to provide the anterior segment surgeon a cost-effective and space-saving solution for treating both glaucoma patients undergoing selective laser trabeculoplasty (SLT) for open-angle glaucoma and pseudophakic patients in need of Nd:YAG laser capsulotomy for secondary cataracts, as well as iridotomy for closed-angle glaucoma. This provides three treatments in the one machine.
TRI-LASER SYSTEM UPGRADEABILITY
The LightLas Deux TM can easily integrate with other LightMed Lasers such as the LightLas Yellow577, Green532 and Diode810 Laser Photocagulators making the DeuxTM complete work station, complementing their needs to succesfully manage ocular diseases, and broaden their practice dynamics and possibilities in a simple and cost effective way.
CRYSTAL Q-SWITCH TECHNOLOGY
The LightLas DeuxTM is equipped with the latest Crystal Q-Switch Technology cavity, that ensures low energy optical breakdown, with reduced trauma to the eye. This asures exceptional life span, achieving the expected tissue disruption with less than the usual required, and having particular benefits for patients with soft IOLs that are sensitive to pitting. The shot-to-shot output energy is also very consistent and accurate, so the physician is confident of delivering excellent tissue disruption every time.
FULLY INTEGRATED SYSTEM
The LightLas DeuxTM has an integrated slit lamp, which is combined with the laser head and contains all the laser modules (SLT and photodisruptor.) The high quality slit lamp can also be operated as a normal examination slit lamp, providing the doctor with a diagnostic and treatment system in one package.
BEAM SPLITTER FREE INTEGRATED DESIGN
The LightLas DeuxTM does not have a beam splitter between the objective lens and the focal plane — thanks to its integrated slit lamp delivery system design. A beam splitter introduces astigmatism and color distortion of the image, resulting in optical aberrations that reduce the quality of view. The LightLas Deux's integrated design allows the beam splitter optic to be eliminated, thereby increasing the working distance between the laser aperture and the patient. This extra working distance gives the doctor more room to manage the patient's position and to hold the lens. This is truly good news for the doctor. In addition, the LightLas Deux's quality European optics offer the best performing laser slit lamp system on the market.
The LightLas DeuxTM features a specially integrated slit lamp with precision optics specifically designed for laser application. The system is fully compatible with observer tube, video, or 35 mm camera accessories.
DOCTOR AND PATIENT COMFORT AND ACCESSIBILITY
For the physician, the LightLas DeuxTM features dual handed controls, and a large working distance between the objective lens and the patients eye. A small working distance from their eye pieces reduces the strain on the back when operating.The large format, easy to read displays, and controls within convenient reach, make the LightLas DeuxTM the most user-friendly laser system available.
COLOR-BALANCED SAFETY FILTER
The color-balanced safety filter is fixed to the laser path to provide safe operation for the doctor and to eliminate any obtrusive noise and potential mechanical or electrical failure.The clear optics provide an excellent view and very low color distortion, especially when the LightLas Deux's TM is used for photodisruption and normal slit lamp examinations.
The ergonomic and slimline design of the system combined with the integrated slit lamp make the LightLas DeuxTM the most comfortable system to operate in the market, far ahead of the competitors. There are minimum restrictions to movement for doctor and patient, and no awkward/limiting working distance or obtrusive mechanical noise. The dual handed controls make operation easy and the backlit large-format display and silicone keypad provide easy view of the parameters and buttons without need to move the head too far out of the binoculars making operation in a dark room easy.
The LightLas DeuxTM has been cleverly designed based on modular construction. This philosophy increases reliability, and simplifies service and maintenance. The benefits to the customers include long and reliable operation and minimum system down time, due to ease of periodical maintenance and diagnosis.
NO EXTERNAL CABLES
Unlike most Clip-on SLT designs, the laser head connecting cable is hidden from the doctor. This avoids any unnecessary 'clutter' on the work surface and prevents accidental cable damage during operation.
INTEGRATED FIVE-POSITION MAGNIFICATION CHANGER
The system is supplied with an integrated five-position magnification changer that provides great flexibility for diagnostic and treatment. This clever and ergonomic design allows optimal view of fine structures and wide field view of the retina. The magnification changer is easily removed if the doctor prefers not to use it
OPTIONAL TONOMETER MOUNT
With the use of the Tonometer Mount accessory, the LightLas DeuxTM slit lamp can accommodate the use of a Haag-Streit Goldmann Applanation Tonometer for the measurement of intraocular pressure (IOP) for glaucoma patients. This feature enhances the diagnostic capability the LightLas DeuxTMas a great diagnostic and treatment workstation.
CONVENIENCE AND QUALITY AT UNBEATABLE PRICE
Yes, it is not always the case that quality and piece of mind can be acquired at competitive rates. However , LightMed's traditional fair business model offering 'the industry's best value for money lasers' has been manifested in the LightLas DeuxTM.
SLT is derived from selective photothermolysis, which is based on three principles:
- Absorption of intracellular targets must be greater than that of the surrounding tissues (For visible wavelengths, melanin is an abundant chromophore in the trabecular meshwork.)
- A short pulse is required to generate and confine heat to the pigmented targets, and the wavelength must match the absorption wavelength of the target (The absorption of melanin is significant over a large spectrum.)
- The pulse duration must be less than the thermal relaxation time of the target.
When all of these parameters are achieved, target specificity is independent of focusing. Typical SLT parameters are:
- 3 nanoseconds pulse width
- Q-switched, frequency doubled Nd:YAG laser (532nm)
- Power = 0.5 - 1.0 mJ (average)
- 400 micron spot size
MECHANISM AND EFFICACY OF SLT
The natural restoration process of the Trabecular Meshwork cells is inteligently triggered through a number of steps, and is achievable only by an SLT laser. This mechanism consists of the following steps:
- Macrophage recruitment takes place to remove damaged cells.
- Trabecular meshwork cells divide to replace the lost cells.
- Release of growth factors (cytokines, MMP's) which regulate the structure of the TM beams.
- A healthier, more porous trabecular meshwork restores balanced aqueous outflow.
- This process occurs differently from person to person but typically takes about a week.
- Effective in approx 75% of patients, 25% reduction in pressure.
YAG LASER POSTERIOR CAPSULOTOMY
Nd: YAG Laser Capsulotomy is the most successful and frequent indication of YAG laser application for removal of the secondary cataract tissue. It has long replaced surgical discussion by Zeigler's knife of posterior capsule as a much safer alternative.
- Posterior capsular opacification (PCO) causing reduced visual acuity and or excessive glare.
- PCO with inadequate or very small YAG capsulotomy opening.
- Capsular distension following retention of residual viscoelastic material between posterior surface of intraocular lens (IOL) and transparent posterior capsule (In Cap [sulorhexis] clinically suspected by myopic error of refraction in postoperative follow up).
- Re‐opacification (post Nd: YAG capsulotomy).
A YAG laser peripheral iridotomy (PI) is performed as the standard treatment (exclusively) for patients with Narrow Angles, Narrow angle Glaucoma, or Acute angle Closure Glaucoma.
Narrow Angle Glaucoma
There are a number of different types of glaucoma, and these glaucoma conditions have in common the fact that the pressure inside the eye is raised, and that this causes damage to the optic nerve, and to the field of vision.
Narrow angle glaucoma refers to a situation where the rise in IOP is due to obstruction of the flow of aqueous fluid out of the eye, because access to the normal drainage channels is obstructed by the narrowness of the angle between the iris and the cornea. In a normal eye, aqueous fluid is formed in the ciliary body behind the iris, and circulates over the surface of the lens, through the pupil, into the anterior chamber, and finally out through the trabecular meshwork.
Normally there is no obstruction of flow to the trabecular meshwork, but in some situations the access to the meshwork is closed off because the space between the iris and cornea becomes too narrow. The reason that this situation arises is related to the size of the eye, the size of the lens, and the size of the pupil.
YAG LASER MEMBRANECTOMY
YAG laser membranectomy is effective in reopening blocked glaucoma tube shunts. Thick nonelastic papillary membrane in front of the intraocular lens caused significant reduction of vision often restricted to perception of light and projection of rays. It is a very important to assess thickness, density and type of membrane by slit‐lamp biomicroscopy.
- Inflammatory papillary membrane after extra capsular extraction of lens with or without posterior chamber intraocular lens particularly in diabetic patients and patients with residual cortical matter.
- Patients with above indication and poor risk for further surgical procedure.