LIGHTLas SLT

About LIGHTLas SLT

LIGHTLas SLT is a trademark product of LIGHTMED Corporation, considered as the industry’s best SLT Laser.   It is the most popular and widely applied laser photodisruptor in the market, providing unmatched blend of quality, precision, and features complemented by unmatched price.

The LIGHTMED’s SLT was designed to maximize the workflow of most dynamic practice in treatment of glaucoma procedures with ease, safety, and precision.yag 8 copy

 

Laser type Q-switched; Frequency doubled YAG
Wavelength 532nm
Energy range 0.2-2.6mJ per pulse; continuously variable in 0.1 increments
Pulse width 3ns
Burst mode Single Pulse
Mode structure Frequency-doubled; Diffraction limited
Spot size 400 µm
Cone angle < 3 degrees
Treatment beam offset 10 mm; fixed
Laser repetition rate Less than or equal to 2.5Hz
Aiming beam 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 (L) x 54cm (W) x 54cm (H); 28" x 21" x 21"
Weight 21Kg / 46.3 lb (system); 30Kg / 65 lb (packaged)

Features and Benefits

Thermal KTP Crystal Management

The new LIGHTLas SLT Deux and LIGHTLas SLT Solo feature an exclusive Thermal KTP Crystal Management circuitry and software, which assure most stable SLT output energy performance over high repetition firing.

Due to its physical properties, the KTP crystal which converts the Screen Shot 2014-09-02 at 3.15.17 PMYAG (laser cavity) wavelength to 532nm (SLT wavelength) may expand and alters its output energy linearity due to frequent firing of the laser as industry guidelines allow a ±20% error.  This may often affect the treatment precision and its actual clinical outcomes.

LightMed’s proprietary technology eliminates the KTP variations engaging a special thermal control mechanism and circuitry that assure optimum shot-to-shot performance and reduce the energy variation error to more than double of competitors.

Smart and Ergonomic Integrated Design

The LIGHTLas SLT was designed for physician and patient comfort for fast and convenient operation. Its ergonomic and uniquely integrated design makes it the most functional and comfortable SLT laser to operate.

The laser permits for convenient dual handed controls, and exhibits short working distance between the objective lens and the patient’s eye, thus reducing back strain for the user.

An externally mounted chinrest facilitates convenient accommodation of patient posture, enhancing their comfort and in-treatment participation.

Quality Precision Optics

The LIGHTLas SLT features excellent quality components and high-resolution slit lamp optics, optimized for anterior segment procedures.

Whereas the beam splitter free design with internally coated safety optics as opposed to fixed safety filters, assure unmatched procedural viewing clarity and larger field of view compared to most contemporary lasers in the market.

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Built-in Five Position Magnification Changer

5 step changerThe LIGHTLas SLT features a five-position magnification changer. When combined with the laser’s enhanced optical design, it assures greater flexibility for diagnostics and treatment outcomes.

The design allows optimal viewing of fine structures and a wide field view of the treatment area, whereas the integrated design minimizes the working space (length) assuring convenience for the physicians.

 

Superb Crystal Q-switch Laser Technology

Unique Crystal Q-Switch laser cavity technology provides optimum tissue cutting precision and consistent shot-to-shot output gaussain-sltenergy at industry’s lowest optical breakdown levels.  This reduces the noise associated with photodisruption, assuring better patient compliance and allowing procedures to be done with lower energy levels, reducing treatment side effects and lens pitting.

The 3Hz system design assures superb energy density and sets the LIGHTLas SLT amongst the fastest systems in the market, allowing fast yet highly precise and safe treatments.

 

Unmatched Long-term Performance with Auto Calibration

The already superb, fast and reliable laser is further complemented by proprietary auto-calibration function, which assures exceptional laser cavity life span.

laser lifespan slst soloUnlike other lasers in the market that require frequent maintenance to promote its life span, the LIGHTLas SLT will intelligently engage in auto-calibration mode as soon as the microprocessor senses degradation in output power over the predetermined levels.  The laser will self diagnose and set optimum internal parameters to continually assure peak performance regardless of the laser age.

This unique feature significantly enhances the overall costs of ownership and reduces service requirements, yet assures safety and convenience.

 

Convenient and Easy Controls

The LIGHTLas SLTfeatures large, clear displays with easily accessible controls, making it amongst the user-friendliest SLT lasers available.controls 3 copy

Laser parameters can be seen and adjusted beneath the oculars, limiting the distance the user needs to move during procedures, assuring adequate procedure focus and attention.

 

Unique YAG/SLT Duo™ Upgradeability

slt shadowThe LIGHTLas SLT is the only system in the market that conveniently upgrades to the dual YAG/SLT modality, significantly increasing the product value and its clinical versatility.

Instead of buying an entirely separate YAG laser, the owner of the LIGHTLas SLT can request an upgrade at any time, permitting the capital outlay to be spread for a desired period of time.

The YAG/SLT upgrade will enhance practice dynamics, space, cost-efficiency, and optimizes workflow through a single system solution.

 

LIGHTLas YAG Duo™ Upgradeability

Alongside the YAG upgrade, the LIGHTLas SLT can also adapt with one of LightMed’s unrivaled photocoagulators, creating a powerful multi-purpose anterior and posterior laser workstation.

This combination assures maximum cost and space saving capabilities. Whereas integration with one of LightMed’s new generation 532nm (green) or 577nm (yellow) and 810nm (infrared) photocoagulators, which utilize conventional and sub-threshold treatment mode technology, make the LightLas Duo a powerful combination platform.

The Photocoagulator treatment laser is delivered through an attachment type delivery system that conveniently mounts on the LIGHTLas SLT without affecting its core performance. The laser console can be conveniently located on a specially designed swivel plate for enhanced functionality, or mounted on the side column for enhanced space.

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Advanced Firing Mechanism

Most contemporary SLT Lasers in the market use older generation slit lamps, which apply slip rings within the internal joystick mechanism to trigger the laser.  In time, the coating of the slip rings wears off, increasing the possibility of misfire in desired position.  The LIGHTLas SLT features a direct fire-to-joystick- switch mechanism that assures perfect performance regardless of product age and position of the joystick.

Effortless Precision

The LIGHTLas SLT allows for precise yet simple adjustment and setup of the laser at the treatment area.

The design adapts a single de-focused system that creates a single beam, which appears sharpest with internally visible rings once adjusted to the focal target area.

The aiming beam is the size of the actual treatment beam which all assures a high degree of precision yet offers the comfort of effortless laser adjustments.

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Innovative Modular Design

The LIGHTLas SLT has been intentionally designed with an intelligent modular construction. This design 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 limited periodical maintenance and diagnosis.

SLT Clinical Applications

What is Selective Laser Trabeculoplasty

Selective Laser Trabeculaplasty, widely referred to as SLT is simple, yet highly effective laser procedure that reduces the intraocular pressure associated with glaucoma.

SLT treatment uses short pulses of low-energy laser light to target the melanin in specific cells of the affected eye, triggers body’s natural healing mechanisms to rebuild these cells and does not cause any collateral damage to the underlying structure.

SLT-1

SLT Fundamantals

  • 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 (fixed with LIGHTLas SLT)
    • Q-switched, frequency doubled Nd:YAG laser (532nm)
    • Power = 0.6 – 1.2 mJ (average)
    • 400 micron spot size  (fixed with LIGHTLas SLT)

Mechanism and Efficancy of SLT

  • The natural restoration process of the Trabecular Meshwork (TM) cells is intelligently triggered through a number of steps 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.

    SLT-2

    SLT-3

SLT Characteristics

  • The SLT can be distinguished by its unique characteristics as;

    Smart

    Stimulates the body’s natural mechanisms to enhance outflow of the fluid in the eye.

    damage to non-targeted tissue.

    Selective

    Selectively targets only the melanin-rich cells of the trabecular meshwork. The point and shoot approach of ophthalmic laser treatments that has been used in the past

    three decades, will soon become extinct. Today, ophthalmologists want to achieve spatial

    and tissue biological selectivity. SLT selectively targets specific tissue, causing minimal

    Safe

    SLT is not associated with systemic side effects.

    Conservative

    With SLT, normal trabecular tissue is minimally affected, in a similar manner to photodynamic therapy for treatment of macular degeneration. Through a photochemical mechanism, the choroidal neovascular membrane is heated, but the overlying neurosensory retina is minimally damaged.

    Non-Collateral

    SLT is a non-thermal laser treatment. The short pulse duration of SLT is below the thermal relaxation time of the TM tissue, thereby eliminating the incidence of thermal damage. Non-thermal laser treatment uses a photochemical activation mechanism, such as the mechanism used in photodynamic therapy for treatment of macular degeneration, in which sub-thermal light does a drug in-situ. Non-thermal laser treatment also uses short-pulsed laser to decrease heat damage to adjoining tissue. An example of this process is the use of a short-pulsed CO2 or Erbium:YAG laser to selectively remove epidermis.

    Repeatable

    Treatment can be repeated without causing harm or further complications. It is One of the major advantages of SLT is repeatability. If the initial SLT achieves inadequate IOP control, subsequent SLT treatments can be performed to further reduce IOP, without adverse effects. In contrast, studies of patients treated with ALT show that multiple ALT treatments damage the trabecular meshwork.

    Sensible

    Established as standard proven therapy, reimbursed by insurance providers minimizing out-of pocket expenses.  It offers a great alternative also to patients who do not have the regime to take medications daily for the rest of their lives and, or subsequently find medication as expensive.

    Effective

    Data collected over 10 year from various clinical studies demonstrate the SLT to be an effective and successful treatment in 75% of cases, achieving a 25% reduction in IOP pressure. SLT is thus recommend as first line approach or ideal adjacent to medication as Combined treatment.

     

SLT or ALT

SLT treatment provides unmatched benefits as the better Laser Trabeculoplasty procedure when compared to ALT;

  • Effective as first line treatment.
  • Easier to perform (focusing not critical).
  • Works even on very lightly pigmented TM’s
  • Can be performed in presence of synechiae. (the iris adheres to the cornea or to the capsule of the crystalline lens).
  • No structural change & coagulative damage.
  • Reduced side effects (e.g. inflammation).
  • No membranes – no Peripheral Anterior Synechiae (PAS).
  • Repeat treatments, give repeat IOP reduction.

SLT-5

SLT or Medications

The SLT procedure has been clinically proven to be a successful and effective as first line treatment in the fight against primary open-angle glaucoma (POAG) for well over 10 years.

In most POAG patients, SLT reduces intraocular pressure (IOP) significantly for a few years without any major or permanent side effects or complications. Consequently, the idea of potentially gaining some drug-free years for a newly diagnosed POAG patient by using SLT as the initial therapy is becoming increasingly more appealing.

Some Ophthalmologists however, are still reluctant to use SLT in this situation due to the reputation of argon laser trabeculoplasty (ALT) as damaging to the anterior chamber angle structures and its unrepeatability, further aggravated by the aggressive marketing approach of pharmaceutical companies to promote medication as the easy and primary option.

Whilst medications may still be the easiest organic approach by most Ophthalmologists today, undoubtedly the most significant problem with eye drops is patient compliance. Since most POAG sufferers have no noticeable symptoms (except to their doctor) they are not reminded by pain or loss of function to take their medicine.

A recent patient survey found that approximately 33% of patients who are presented a glaucoma prescription at a pharmacy never picked up the medication thus SLT approach enables:

  • Control of patients’ treatment effectively lowering IOP without compliance issues and side effects associated with drug therapy.
  • SLT is particularly appropriate for individuals who cannot correctly administer, or are intolerant to, glaucoma medications
  • Can also be used effectively in conjunction with drug therapy

Further, among patients who started taking medications for the first time, only 40% took the medication for the full year.  In patients already on other glaucoma medications, only 64% finished the year taking a medication (e.g. prostaglandin), and less than half (44%) complied with their dosing regimen for other medications.

Other common difficulties (excluding Patient’s lack of rigour and persistence) facing glaucoma medication approach only are;

  • Intolerance to medication.
  • Limit to how many medications the patient can take.
  • Non compliance with medication regimen (e.g. literacy, religion)

Then there are of course cost and side effect concerns associated with glaucoma medicines.  Most commonly include:

  • Patient discomfort (e.g. itching, burning, redness of the skin surrounding the eyes)
  • Changes in pulse and heartbeat and breathing (especially in patients with asthma or emphysema).
  • Changes in energy level.
  • Dry mouth and eyelash growth.
  • Blurred vision and change in eye colour.
  • Often expensive and some need to be taken for the rest of patient’s life.

It is important to consider that also approximately 34% of glaucoma patients don’t respond to medication, whilst topical glaucoma drops increase possibility of ocular surface infection by 38%.

Finally, it is almost inevitable that medications needs to be taken either daily or in many cases for the rest of patients life so ‘medication as a low-cost option’ seems viable only at the beginning.

If you or your patient  were experiencing problems with your glaucoma medication, wouldn’t you appreciate your a treatment that…

  • Provides prolonged reduction of intraocular pressure.
  • Alternative for patients who do not respond or are noncompliant with medication.
  • Complementary or adjunct to medication.
  • Sustained IOP reduction post-surgery.
  • Same effective response between low and high pigmented eyes.
  • Does not produce peripheral anterior synechiae.
  • Proven safe and effective.
  • No side effects and can be repeated if necessary.
  • Simple and fast with little to no discomfort.

SLT Treatment Guidelines

The following treatment guidelines are based on the generic results of clinical studies and provided to serve for common purposes only. We recommend that it is ophthalmologist’s responsibility to familiarize themselves with the latest recommended techniques and apply protocols based on assessment of specific patient and their condition.

Patient Selection

Research has demonstrated that SLT treatment is suitable for majority of patients suffering increased IOP that qualifies for means of IOP reduction.  Primary suited patients;

  • Require immediate IOP reduction as means of primary or secondary treatment.
  • Unlikely to comply and/or persist with drug therapy.
    • Difficulty administering eye drops.
    • Drug therapy induced side effects.
    • Affected quality of life due to drug therapy.
    • Failed drug therapy.
    • Failed ALT treatment,
    • Failed SLT treatment, or first SLT proved insufficient
    • Normal tension glaucoma.
    • Ocular hypertension.

Treatment Considerations and Contra-indications

Special approach and care needs to be taken in cases where;

  • Treatment on Pigmentary Glaucoma patients require high degree of caution due to increased risk of post-SLT IOP spike.
    • Treat maximum one quadrant (360º ) of TM
    • Maintain maximum energy at 0.4mJ – 0.5mJ
    • Use a prophylactic agent to avoid post-op IOP spike; andNSAID to avoid post-op inflammation.  Assure strict follow-up (minimum one hour post procedure, with subsequent follow up in 24 hrs. then two weeks, six weeks and in three months)
  • Restricted or Unclear view of the Trabecular Meshwork (TM).

SLT has not demonstrated high level of efficacy on;

  • Paediatric and Juvenile glaucoma patients.
  • Primary or secondary narrow-angle glaucoma.

SLT procedure is not recommended for;

  • Patients with Inflammatory or Uveitic glaucoma.
  • Patients with neovascular glaucoma (NVG)

Pre-Treatment

Pre-operative medications typically include an alpha agonist (e.g brimonidine), and topical anaesthesia, such as proxymetacaine hydrochloride. Recommended especially heavily pigmented patients and when performing 360° TM treatment.

Treatment

Even after more than 20 years of successful SLT use worldwide, its regimen continues to evolve and the exact protocols vary of 360º, 270º, 180º and 90º of TM treatment.

The approach often remains at the physicians’ preference, although research has demonstrated that also the ethnic background should be factored in deterring the adequate protocol, as it plays an important role in efficacy of the SLT procedure outcomes.

Generally it is assumed the 360º or 180º TM treatment as most common considering:

  • 360º treatment of TM provides the best therapeutic results, however the more assertive the treatment the higher the risk of inducing a post-op IOP spike, which diminishes within 24-48 hours.
    • Typically 100 non-overlapping laser pulses around the full circumference of TM.
  • 270º treatment of TM offers a higher degree of assertiveness, but provides slightly reduced risk of large post-op IOP spike.
    • Typically 75 non-overlapping laser pulses with nasal half for first 180º
  • 180º treatment of TM is also commonly used reducing the prevalence of post-op IOP spike, although the degree of treatment success rate varies.
    • Typically 50 non-overlapping laser pulses recommend treating the inferior or the nasal half of the TM due to variations in pigmentation levels.
  • 90º treatment of TM is applied in cases where extra caution needs to be taken due to highly increased risk of post-op IOP elevation and contra-indicated conditions.
    • Typically 25 non-overlapping laser pulses treating the inferior or the nasal quadrant.

Contact Lens

  • Latina SLT Gonio lens is recommended as the primary option for SLT procedure.
  • Other Gonio lens may also be used, however it is recommended to always consider that some magnified lens may affect the spot size and treatment power density altering the safety and efficacy of procedure.
  • Viewing with other non-magnified lens can be compensated by increasing slit lamp magnification, although to maximise the viewing angle the Gonio lens such as CGA-1 provides adequate angle further reducing the need of frequent lens rotation.

Spot Size Adjustment

LIGHTLas SLT treatment spot size is pre-set at 400μm in line with acknowledged SLT protocols. The spot exposes the whole width of the TM, with marginal excess (overspill) beyond the TM edges. There is no concern as the nature of SLT treatment is non coagulative, whilst the iris overspill is assumed to further enhance the procedure outcomes.

Whilst the aiming of the laser is easier and considered not as critical as in ALT procedure, It is important to obtain a clear view of the TM and assure treatment spot focus must target tissue.

Treatment Steps

1. Determine the optimal treatment power for each patient, by setting the laser initially at 0.6mJ (set the energy at 0.4mJ for patients with heavily pigmented TM).

a) Apply laser and adjust the energy in 0.1mJ increments until the therapy point is identified (observed as mini-bubble formation (champagne effect or micro cavitation bubbles)).

2. After the therapy point is achieved, reduce the energy by 0.1mJ and maintain that as the threshold energy level during the procedure.

a) LIGHTLas SLT features an exclusive KTP management system ensuring superb energy stability, however due to possible TM pigment variations it is recommended to reassess the energy threshold commencing treatment of each quadrant.

b) Heavily pigmented TM will typically require lower energy levels in order to achieve the adequate thresholds (approximately 0.6mJ – 0.8mJ)

c) Lightly pigmented TM will typically require higher energy in order to achieve the adequate thresholds (approximately 0.8mJ – 1.3mJ)

3. To ensure optimum clinical outcomes it is important to consider that pigmentation may often differ between the superior and inferior halves. Therefore it is highly recommended to titrate the power levels accordingly to the treated area, splitting at each half or quadrant depending on the applied protocol  (depending on the degree of TM coverage);

a) Treat the nasal half for first 180° treatment then target temporal half.

SLT-7

b) Treat the nasal half for first 180° treatment then target temporal half.

SLT-8

Post Treatment

  1. Patient follow-up should be done typically within 1-hour after procedure (IOP check) and addressed adequately to their risk of a post-op IOP spike.
  2. Non-steroidal anti-inflammatory drops (NSAIDs) are applied four times daily for three to five days (It is not recommended to apply steroidal medication to prevent their interference with the SLT treatment).
  3. For patients with low risk of post-op IOP spike, the typical follow-up visits are scheduled at two weeks, one month, three months and six months after the treatment. Subsequent visit in 6 months thereafter to ensure stable IOP.

Expected Results

  • Successful drop in IOP should occur within 1 – 3 days post SLT treatment (although it is common to observe a slight IOP increase within the first day post procedure)
  • SLT has demonstrated efficacy in approximately 75% or patients offering a sustainable IOP reduction, although ongoing monitoring is advisable, as SLT does not provide a permanent cure if not repeated or unsupervised.
  • Certain patients may respond after several weeks (typically a notable drop of IOP within 3 – 6 weeks is a good indication of successful procedure).

Potential Side Effects

There are minimal observable side effects resulting from SLT treatment; these include mild discomfort during the procedure and tender eyes, perhaps with mild photophobia, for 2-3 days.

The absence of adverse side effects is one of the major benefits of SLT treatment.

In a small percentage of cases (<10%) some postoperative increase in IOP has been observed, usually appearing within the first 24 hours and disappearing within a further 24 hours. However, a few cases of sustained IOP increase requiring follow-up treatments have been reported.

Re-Treatment

If required, its advisable to allow up to three months before re-treatment as some patients may exhibit delay in IOP reduction after the initial SLT procedure.

  • If initial procedure covered 180º of TM, treat the opposite 180º
    • It is common that during re-treatment physician will apply an enhancement approach, treating exultingly applied and additional 180º of the TM.
  • If initial procedure covered 360º of TM, repeat the procedure.

SLT Clinical Hints

The following hints are conducted LightMed clinical research, claimed by some committed physicians using the LIGHTLas SLT lasers as well as their publically available journals and published papers.  The physician assessing their patient and condition should only determine treatment protocol.

General Approach Observations

The use of SLT Latina lens is vital for adequate procedure protocols; it is crucial that patients are well compliant and comfortable during the procedure.

  • Patient should always be instructed to look towards the mirror (extremely helpful, when treating eyes with a narrow angle inlet & posterior annual synchiea (also known as iris bombé)). After each lens rotation, the patient is instructed to change the gaze and follow.”
  • In cases of posterior annual synchiea (also known as iris bombé), the patient should be requested to look towards the lens mirror, rather that trying to move the lens towards the eye.
  • The use of SLT Latina lens is vital for adequate procedure protocols; it is crucial that patients are well compliant and comfortable during the procedure.
    • Patient should always be instructed to look towards the mirror (extremely helpful, when treating eyes with a narrow angle inlet & posterior annual synchiea (also known as iris bombé)). After each lens rotation, the patient is instructed to change the gaze and follow.”
    • In cases of posterior annual synchiea (also known as iris bombé), the patient should be requested to look towards the lens mirror, rather that trying to move the lens towards the eye.
  • In patients with Acute clousure glaucoma treat only the visible area and avoid to not touch the peripheral anterior synchiea. (typically none or minimal peripheral anterior synchiea formation with SLT as opposed to ALT)
  • Blanching may not be apparent with heavily pigmented TM, therefore a small champagne bubble is considered as good treatment power level threshold.
  • To maximise the outcome of the conservative 180º approach, its important to consider that typically the inferior and temporal TM areas are larger than superior or nasal areas, which enhances the visibility of the structures and thereby makes the treatment easier typically when commenced from 3 to 9 o’clock .
  • SLT can be potentially performed in cases of narrow angle glaucoma, as long as the trabeculum can be observed during gonioscopy. When the angle is narrow but remains open, an agonist can be applied (i.e. pilocarpine) to open the angle further, facilitating easier SLT procedure.
  • For patients with convex irises consider pre-op medication such as pilocarpine. Application of brimonidine or apraclonidine an hour prior to SLT treatment will help blunt post-operative IOP spikes.”
  • SLT procedure outcome may be enhanced by washing out the patients from medication (such as prostaglandin-analogs) prior to the procedure, although patient should exhibit a stale IOP.
    • Pre-operative medications typically include an alpha agonist, such as brimonidine tartrate, and topical anaesthesia, such as proxymetacaine hydrochloride. Pilocarpine may be administered to improve visibility of the angle.
    • Physicians at growing rate are opting not to prescribe post-op medications believed to affect the natural mechanism of SLT treatment.
  • Repeated SLT is advisable as standard of care typically at six to eight months post initial procedure, with repeat of the same protocol as initial.  Well responders (patients with notable IOP reduction) have especially greatly benefited by prolonged IOP reduction without the need of any medication
Configurations
LIGHTLas SLT +532 Duo Laser
LIGHTLas SLT +532 Duo Laser
LIGHTLas SLT +577 Duo Laser
LIGHTLas SLT +577 Duo Laser
LIGHTLas SLT + 810 Duo Laser
LIGHTLas SLT + 810 Duo Laser
LIGHTLas YAG/SLT Deux
LIGHTLas YAG/SLT Deux
LIGHTLas YAG/SLT Deux + 532 Tri Laser
LIGHTLas YAG/SLT Deux + 532 Tri Laser
LIGHTLas YAG/SLT Deux + 577 Tri Laser
LIGHTLas YAG/SLT Deux + 577 Tri Laser
LIGHTLas YAG/SLT Deux + 810 Tri Laser
LIGHTLas YAG/SLT Deux + 810 Tri Laser
Accessories and Delivery Systems
Dual Plug Beam Splitter
Dual Plug Beam Splitter
Observation Tube
Observation Tube
Photographic Camera Adaptor
Photographic Camera Adaptor
Video Camera Adaptor
Video Camera Adaptor
SLT Laser Lens (by Volk or Ocular Instruments)
SLT Laser Lens (by Volk or Ocular Instruments)
Iridotomy Laser Lens
Iridotomy Laser Lens
Capsulotomy Laser Lens
Capsulotomy Laser Lens
TruSpot Slit Lamp Delivery Attachment
TruSpot Slit Lamp Delivery Attachment
Slit Lamp Delivery Attachment
Slit Lamp Delivery Attachment
U-Recessed Table
U-Recessed Table
Dual Column Table
Dual Column Table
Downloadable Files

United States

San Clemente, California

1130 Calle Cordillera
San Clemente, CA 92673
USA

phone 949-218-9555

fax 949 218 9556

Japan

Tokyo, Japan

3F Orchis-Takebi, 2-Chome 22-1
Hatagaya, Shibuya, Tokyo 151-0072
Japan

phone +81 3 5333 2411

fax +81 3 5333 2412