LIGHTLas TruScan

TruScan

About LIGHTLas TruScan

LIGHTLas TruScan initiates the next generation of LIGHTMED’s most ambitious ophthalmic laser family.  The newly released mk-2 system features single and dual wavelengths with an intuitive and user-friendly design.

Treatment outcomes are enhanced by pattern scanning laser delivery technology in traditional continuous wave (CW) and tissue friendly sub-threshold modalities, assuring exceptional clinical precision, speed, and versatility.

 

VERSATILITY of 4 WAVELENGTHS

Available with a choice of single or dual wavelengths (532nm Green, 577nm True-Yellow, 670nm Red and 810nm Infrared), TruScan can cater for traditional or highly specialized clinical needs in all types of practices.

TruScan 1

SPEED AND PRECISION THROUGH PATTERN SCANNING TREATMENT

TruScan offers the largest range of customizable patterns, assuring safer and more convenient application of the treatment laser, whether it is for rapid treatment or particular pathology.  Superb optical design and laser cavity technology assure the highest standards of energy density, speed, and precision.  Pattern scanning photocoagulation significantly enhances the conventional treatment outcomes and patient comfort levels.

TruScan-2

EXCEPTIONAL CLINICAL OUTCOMES WITH TRADITIONAL & SUB-THRESHOLD MODES

This superb traditional photocoagulation is complemented by LightMed’s tissue friendly sp-mode™ function, permitting treatment at sub-threshold level while offering safe, versatile, and repeatable management of retinal disorders and glaucoma.

The technology induces relaxation duty cycles by chopping a continuous wave to microsecond pulses, thus reducing the laser-induced thermal tissue damage and laser side-effects.

Tru-Scan 3

Available Wavelengths 532nm | 532nm / 670nm | 532nm / 810 nm | 577nm | 577nm / 670nm | 577nm / 810nm
Power Output Yellow: 2W | Infrared 3W | Red: 700mW | Green: 2W
Mode of Operation Continuous Wavelength
Laser Type Optically Pumped Dual Diode Solid State
Exposure Duration 0.01s – 3.0s; continuously variable
Repeat Interval 0.01 to 3.0s; and single
sp-mode™ Duration 150μs-600µs (50µs increments)
sp-mode™ Duty Cycle 5%-30% (2.5% increments)
sp-mode™ Period 1400µs-1850µs (50µs increments)
Pattern Scanning (disengaged in 670nm and 810nm mode) Single; Line; Square (2×2; 3×3; 4×4; 5×5); Macular Arc (Single; double; triple; 1/4; 1/2; 3/4); Circle and Triangle – Spot width; density and 360 degree rotation available for each pattern
Spot Size Single: spot Continuously variable 50μm to 1000μm; Scanning Patterns: Continuously variable 100μm to 500μm
Safety Class Class 4
Aiming Laser Red laser diode (635nm – 650 nm) 0.1 – 1.0mW continuously variable
Cooling System Fan cooled and TEC's for Laser Diode and Crystal
Dimensions (Console Only) 12 cm (H) x 38 cm (W) x 40 cm (D); 4.7" x 15.0 " x 15.7"
Dimensions (System on Table) 75 cm (H) x 120 cm (W) x 42 cm (D); 29.5" x 47.2" x 16.5"
Dimensions (Console on Trolley) 90 cm (H) x 45 cm (W) x 46 cm (D); 35.4" x 17.7" x 18.1"
Weight Laser Console: 10 kg / 22 lb.; System on Table: 92 kg / 202.4 lb.; System on Trolley: 72 kg / 158.4 lb.

Features and Benefits

Ultra-High Performance Laser Engine Technology

Truscan 4TruScan utilizes highly innovative laser technology, assuring supreme standards of performance and versatility with up to 10 times a higher life span than its competitors.

One of the TruScan greatest hidden features is its diffusion bonding laser cavity design, utilizing advanced coating elements that are applied to the laser optical components.  This proprietary and patented technology maintains peak stability and durability under high stress conditions.

This is a vital advantage over contemporary pattern scanning systems, as laser delivery in sub-threshold or pattern scanning mode requires usage of the laser at high energy levels, forcing the laser to work at its maximum loads.

Superb Energy Distribution Enhancing Treatment Outcomes

The innovative laser technology and superb optical design of the TruScan assure accurate power delivery and precise energy density distribution across the treatment area in both single and pattern scanning mode.

truscan superb energy copyIt has been common practice for other pattern-scanning lasers to compromise their treatment speed by poor laser efficacy, creating a cumulative energy defect or delivering uneven energy within the treated (laser scanned) area.  TruScan produces excellent spot size precision with  accurate energy distribution across every spot size, regardless of the mode of operation.

The all-new digitally controlled instant-duty cycle circuitry allows for a quick laser energy feedback loop that monitors each shot, and instantly adjusts for stable output, enhancing treatment safety and clinical outcomes.

Sub-threshold Photocoagulation in Single & Pattern Mode

TruScan can be used in traditional continuous wavelength (CW) and sp-mode™ (sub-threshold photocoagulation) treatment modalities, allowing conventional and next-gen approach for effective management of retinal diseases and glaucoma.

The sp-mode™ is the latest evolution in LightMed laser photocoagulators, offering a promising approach to achieve optimum clinical outcomes while eliminating laser-induced thermal tissue damage and treatment side effects.  This technology allows for a broader range of treatment choices. Ongoing studies demonstrate that this product is highly effective, and has the ability to treat disorders at a much earlier stage. It also has the possibility of repeatable treatment in retinal applications and glaucoma.

TruScan uniquely permits the use of its sub-threshold mode in single and pattern scanning treatment. This offers the possibility of enhancing the clinical efficacy of the tissue friendly procedure, as it generally does not produce a visible burn mark.
conventional green sp mode green green

The sp-mode™ is not a replacement to conventional continuous wavelength (CW) photocoagulation, but a very variable complement.When added with the pattern scanning modality and multi-wavelength options, the TruScan becomes a very powerful tool for the most discerning physician.

sp-mode™  treatment has demonstrated great efficacy on a large number of clinical applications including:

  • Diabetic macular edema.
  • Macular edema secondary to retinal vein occlusion.
  • Proliferative and non proliferative diabetic retinopathy.
  • Sub-threshold laser trabeculoplasty.
    • Used to reduce intraocular pressure in primary open angle glaucoma.
    • Similar outcomes to conventional microsecond-width pulse laser trabeculoplasty.

sp-mode™ sub-threshold photocoagulation clinical highlights include:

  • Possibly of treatments in the macular region as due to fovea- friendly properties.
  • Photocoagulation is painless with a 10-fold safety margins increase compared to traditional CW laser photocoagulation.
  • More efficient treatment with reduced risk of post-op complications.
  • Less destruction of healthy tissue allowing for repeatable retinal and glaucoma treatment.
  • Can be used in very early stages of the disease improving visual outcomes and offering greater range of treatment options.
  • Stimulates the RPE to function better, and naturally releases the cytokines that modify the genetic expression and the production of VEGFs.
    • Demonstrating high efficacy as first mode of treatment in retinal disease.
    • Viable alternative or great adjunct to the intravitreal anti-VEGEF injection therapy.

Four Customizable Wavelength Options

TruScan is the only laser in its class with a choice of 4 customizable wavelength options in single or dual configurations. It includes conventional continuous wave (CW) and sub-threshold modes in single spot or pattern scanning delivery.

LightMed’s TruScan is also the only laser in the market that allows the physician to acquire the system with a single wavelength and to later add an additional wavelength of choice.  Typical TruScan wavelengths configurations include:

  • Ÿ532nm Green                                            Ÿ
  • 577nm Yellow
  • Ÿ532nm Green / 670nm Red                     Ÿ
  • 577nm Yellow / 670nm Red
  • Ÿ532nm Green / 810nm Infrared             Ÿ
  • 577nm Yellow / 810nm Infrared

Since each of the laser wavelengths offer diverse and unique absorption properties, the system can easily adapt to traditional or highly specialized fields.Truscan 6

The laser console is easily detachable, meaning that it can be conveniently used as traditional laser with endo-probes and LIO. Furthermore, this makes the TruScan the most versatile and powerful laser photocoagulator package in the market.

Largest Selection of Customizable Pattern & Spot Sizes

TruScan offers the largest selection of automated delivery patterns indicated for most pathologies. Each of the selected patterns can be altered by size, density, separation, and rotation through intuitive on-screen commands. Every selection is guided by the micro-joystick, assuring precise target positioning.

TruScan parfocal spot sizes are easily adjusted through continuously variable control, varying from 50µm to 1000µm (100µm to 500µm in pattern scanning mode), offering a great range of treatment spot size for precise clinical requirement.TruScan-2

The pattern scanning galvanic system is controlled by sophisticated software, assuring constant and accurate spot control and automatically enabling or limiting the choice of available patterns based on selected treatment power and spot size. This prevents accidental selection of patterns for incorrect pathology, and assures the user cannot fire the laser in undesired conditions.

The intensity of the aiming beam reduces to 50% during laser application, allowing the physician to precisely observe the tissue reaction during treatment.

Ultra Fast, Highly Accurate Treatment

TruScan is the fastest and most accurate pattern scanning system in the market.  The superb dual-galvo scanning system delivers a grid of 25 laser shots in 274 milliseconds (1/4 second), enhancing treatment speed and procedure workflow.Truscan -7

The new generation software, with instant-duty cycle feedback loop, continuously monitors the laser stability, assuring high-energy delivery precession for each spot.

The advanced optical design and laser cavity assure quick and  precise treatment, enhancing procedure outcomes through speed and safety.

  • Treatment speed is particularly important when treating patients suffering from uncontrollable eye movement (i.e. Diplopia).
  • Enhances practice workflow allowing a PRP procedure to be done in 5 -7 minutes (typically consisting of 2000 – 3000 laser shots).
  • Increased patient comfort through faster treatment at lower threshold levels (in conventional photocoagulation and sub-threshold treatment).

Smart Joystick Manipulator for Fingertip Controls

truscan joystickThe integrated micro-joystick provides superb fingertip precision for positioning and control of  treatment spots and patterns.

The intelligent design achieves a unique sense of control, enhancing treatment experience, speed, and precision.

Advanced LCD Touch Screen Interface

TruScan features an intuitive, large 11.6” back lit color LCD touch screen, packed with numerous easy menus, allowing for convenient selection of laser scan patterns and treatment settings.

The LCD interface functions on a Windows-embedded platform, designed to  allow greater personalization of the system with the ability to store and retrieve personal data such as clinical protocols and system manuals.

The control system and interface design highlights include:truscan screen

  • Customizable treatment parameters and functions.
  • User-friendly interface with language customization.
  • Built in patient database capability.
  • Preferred treatment settings storage.
  • Unlimited user selections.
  • Build in help and system manuals.
  • Windows platform operating system for easy connectivity with practice management system.
  • Easily upgradeable and customizable.

Ergonomic, Integrated and Portable Design for O.R and Office

TruScan was designed to serve as a highly versatile laser for use in clinical and O.R. environments.  The system is configured as a slit lamp & table integrated package with sophisticated and intuitive functions. The laser console easily detaches from the table, and can serve as easily portable O.R. laser solution.  The ergonomic design highlights include:

  • Superb quality slit lamp integrated scanning system
    • Modified optics especially for retinal laser procedures.
    • Offers unique sense of control with extended working space (less back strain to hold the laser lens and more room to work with patient)
    • Achieves a clear visualization and enlarged view of the retina due to superb filter coating.
    • Easily detachable laser console for use as portable laser in O.R.
    • Comes with convenient remote control for use in O.R. or for use with attachment mode.
  • Dual port laser connection for uncompromised use of the TruScan
  • LIO, Endo or other delivery devices:
    • Optional hospital cart to enhance laser console portability.
    • Highly practice for use in O.R. environments.
    • Space saving option if used as laser console only device.
    • Supplied with batter back-up, assuring uncompromised procedure in case of electrical failure.

trolly + truscan
The laser system can also be configured as a single portable laser console. It is available with standard delivery devices such as Slit Lamp Attachment, LIO, ENO. The TruScan can also serve in combination with other LightMed lasers, such as the YAG and SLT for maximized space and cost efficiencies.

Wireless Foot Pedal with Power Control Function

TruScan comes with a wireless foot pedal, facilitating its positioning and reducing cable clutter.footswitch copy

This foot pedal allows for easy adjustment of treatment power settings.

The smart and ergonomic design allows for a hands-free operation and an uninterrupted procedure for increased visual focus.  This system provides audible alerts during energy adjustments with the foot pedal, assuring adequate attention span during treatment.

Ultra long-life battery assures minimum 7-year operating time (also provided with standard cable in case of battery failure or wireless interruptions).

Clinical Information

Pattern Scanning Photocoagulation Information


Wavelength Selection

Introduction
TruScan 1
Since the 1960’s the laser photocoagulation has emerged and continues to remain as the “standard of care” treatment for various retinal diseases. It offers a proven, safe and non‐invasive method of treating common retinal conditions, including proliferative diabetic retinopathy (PDR), diabetic macular edema (DME), choroidal neovascularization in age‐related macular degeneration (AMD) and ocular tumors in adults and children. Emerging technologies and wavelengths assure greater than ever safety and clinical versatility for discerning physicians, yet often remain unclear which wavelength should be precisely applied to maximize its clinical potential.

Overview

The most effective wavelengths for retinal photocoagulation are those that present the optimum tissue (human) ab‐ sorption properties. Ultimately these are wavelengths that are poorly absorbed by macular xanthophyll, yet maximally ab‐ sorbed by the melanin in the RPE and choroids, and by haemoglobin.

Although some wavelengths are superior to others (i.e. as is the now with the emerging 577nm Yellow) there are still no ‘one does all’ lasers as different tissues and pigments absorb various wave‐ lengths to different extents, thus each wavelength has its niche, whilst further visual disorders that may be present at the time of treatment (such as opacities, haemorrhages) will often will dictate, what wavelength may be the ideal fit at that given time.

Green 532nm Wavelength

The 532nm green wavelength, with its mini‐ mal absorption by xanthophyll and strong absorption in melanin and haemoglobin, has for many years been considered the “gold standard” for treatment of the reti‐ na. Green laser light is primarily absorbed by the retinal pigment melanin, and is therefore well suited for a variety of treatment applications in the retinal pigment epithelium (RPE) region. This pri‐ marily applies to pan‐retinal photocoagula‐ tion (PRP) therapy.

There are however some clinical limitations when using the 532nm green wavelength to treat in the retina; as absorption occurs at the vitreous level in cases of vitreous haem‐ orrhage, resulting in possible tissue dam‐ age and a decrease in energy available to produce the desired lesion.

Furthermore, if a layer of blood is present in the inner layer of the retina, then an increased energy uptake is produced in the inner retina, preventing treatment of deeper structures, such as a sub retinal neovascular membrane.

As a result, the use of complementing wavelengths to perform retinal treatment such as 577nm yellow, 670nm red or 810nm infrared is often essential and warrants further investigation. The green 532 nm wavelength is the proven standard in photocoagulation.

Wavelength Benefits:

  • Highly absorbed by the melanin present in the Retinal Pigment Epithelium.
  • Well absorbed by haemoglobin

Clinical Assets:

  • Clinically proven to treat large variety of retinal disorders

Main Clinical Applications:

Retinal Photocoagulation

  • Diabetic Retinopathy
  • Pan Retinal Photocoagulation
  • Retinal Tears, Holes & Detachments
  • Endophotocoagulation

Glaucoma

  • Laser Trabeculoplasty
  • Laser Iridotomy
  • Peripheral Iridectomy

Yellow 577nm Wavelength

The 577nm Yellow laser possesses the high‐ est absorption level for retinal haemoglo‐ bin when compared to green and red wave‐ lengths.

The yellow 577nm wavelength exhibits many common characteristics to the green 532nm wavelength, and is suitable to per‐ form all procedures of the 514nm (argon) & 532nm, including iridotomy and laser tra‐ beculoplasty, providing that sufficient power is available (as many yellow laser photocoagulators presently in the market are unable to produce adequate output power. Hence mainly the reason for tri‐ wavelength lasers).

With its characteristic penetration depth, it offers an efficient and smooth alternative to sealing retinal vessels. It also more effec‐ tively penetrates inhomogeneous media such as moderate cataracts.

However, the true yellow 577nm wave‐ length, offers the many additional advantages such as being effective at lower energy levels, improved patient comfort, less light scatter and less phototoxicity.

Compared to the green 532n , the yellow exhibits similar high absorption in melanin and in haemoglobin, which allows for pro‐ duction of visible lesions with low energy settings. However

it also makes it more effective for the treatment of vascular structures.

When treating inside the macular pigment area, yellow creates a more predictable, controlled burn than traditional 514/532nm green wavelengths, resulting in lower scotoma formation.

The physician has more precise control over the interaction between the laser beam and tissue, and can create a visible laser burn with less power and thus less injury to surrounding tissues than with the green wavelength.

Use of the yellow wavelength is also
more comfortable for patients because there is less lateral as well as less axial spread of thermal energy. Because the yellow wavelength is well absorbed,
the power and duration can be decreased and thus the patient is more comfortable.

As the yellow wavelength is longer there is less scatter, which provides for better transmission through lens opacities. As a result, yellow can be used effectively to treat through lenses with nuclear cata‐ racts – using reduced energy levels.

There are a number of other instances
in which the yellow wavelength is superior to the 514/532nm green wavelengths. Yellow is ideal for treating clinically significant diabetic macular oedema and juxtafoveal and extrafoveal choroidal neovascularization, as well

as to perform grid pattern laser in eyes with branch retinal vein occlusion. In addition, given the high absorption of yellow in melanin, it can be considered in the treatment of some eyes with chronic central serous retinopathy because the lack of yellow laser uptake by xanthophyll protects the fovea.

The yellow wavelength has also demon‐ strated itself as the better suited for feed‐ er laser photocoagulation in eyes with retinal angiomatous proliferans.

The yellow 577nm is the new gold standard to treat near the macula.

Wavelength Benefits:

  • Peak absorption in oxyhaemoglobin
  • Negligible absorption by xanthophyll pigments.

Clinical Assets:

  • Safe near the macula.
  • Useful for treating abnormal vasculature.
  • Reduced treatment pain.

Main Clinical Applications

Retinal Photocoagulation

  • Proliferative Diabetic Retinopathy
  • Diabetic macular Edema
  • Occlusion of the branches and central retinal vein.
  • Occlusion of the branches and central retinal artery
  • Pan Retinal Photocoagulation
  • Retinal Tears, Holes & Detachments
  • Endophotocoagulation

Glaucoma

  • Laser Trabeculoplasty
  • Laser Iridotomy
  • Peripheral Iridectomy
  • Sub-Threshold Photocoagulation Laser Trabeculoplasty (spLT)Low light scattering

Red 670nm Wavelength

The red wavelength has excellent proper‐ ties for laser photocoagulation of the retina, providing deep, gentle penetra‐ tion for effective treatment of choroidal vessels.

Red laser light is not absorbed well by haemoglobin. It therefore easily pene‐ trates moderate vitreous haemorrhages. Its penetration depth is ideal for selec‐ tively treating choroidal vessels, without coagulation of retinal vessels.

The absorption characteristics of the red wavelength (659‐670nm) are very similar to those of the 647nm krypton laser. Pro‐ ducing less scatter for better transmis‐ sion through a cloudy cornea or lens, the red wavelength also provides deeper pen‐ etration for effective treatment of cho‐ roidal vessels. It also enables treatment in the presence of a haemorrhage (bleeding) due to its lower absorption in haemoglo‐ bin.

While the 532nm green lasers are consid‐ ered as the “every day” wavelength and the 577nm yellow is becoming more wide‐ ly used, it is often helpful to have red la‐ ser available when faced with more chal‐ lenging cases, such as vitreous haemor‐ rhage; as the red wavelength allows phy‐ sicians to penetrate through the pre‐ retinal, sub‐retinal or intra‐retinal haem‐ orrhage in order to treat the target tissue below.

In addition, the red wavelength is also known to be beneficial when treating retinopathy of prematurity (ROP).

As Red is not absorbed by the macular xanthophyll pigment and can therefore be used for treatments in or around the macular area, whilst ideal for suture lysis.

The red 670nm wavelength is the ideal choice in case presence of opacities.

Wavelength Benefits:

  • Minimally absorbed by haemoglobin.
  • Well absorbed by melanin

Clinical Assets:

  • Excellent for treating through vitreous and retinal hemorrhages.
  • Better penetration through media opacities.
  • Deeper choroidal reach.

Main Clinical Applications:

Retinal Photocoagulation

  • Diabetic Retinopathy
  • Pan Retinal Photocoagulation
  • Retinal Tears, Holes & Detachments
  • Retinopathy of Prematurity
  • Endophotocoagulation

Glaucoma

  • Laser Trabeculoplasty
  • Laser Iridotomy
  • Peripheral Iridectomy
  • Cyclophotocoagulation

Infrared 810nm Wavelength

The infrared 810nm (commonly referred to as the Diode Laser) is a wavelength of unique characteristics, with niche clinical applications, and a great alternative to 532green and 670red wavelengths espe‐ cially when a deep penetration is re‐ quired. However due to the invisible properties, the 810nm is a wavelength that requires more understanding and expertise than the visible wavelengths, hence the reason why it has not gained the mass popularity.

The lesions produced by 810nm lasers are not immediately noticeable as the same lesions produced by green lasers. Com‐ monly, the lesions take a few days to ap‐ pear (depending on the patient), and once they become apparent, they may appear indistinguishable, both in look and clinical feature to the lesions produced by green lasers. During the treatment, the physician can monitor this effect and adjust the power settings by referring to the colour of the retinal lesion, which will usually appear slightly grey.

The 810nm wavelength is less absorbed by melanin than that of the green wave‐ lengths (532nm & 514nm); thus patients with low pigmentation (fair skin) may require higher power settings to photo‐ coagulate the tissue. However, for pa‐ tients with high pigmentation, the differ‐ ence between 810nm and green (532nm & 514nm) wavelengths is negligible.

Because of the invisible 810nm spectrum the diode laser has the advantages of penetrating through sclera, and excessive haemorrhage hance the wavelength has established itself as a standard in niche laser applications such as Retinopathy of Prematurity (ROP), Transscleral Cylcopho‐ tocoagulation or Transpupillary Thermo‐ Therapy, known more commonly as TTT (in treatment of ocular tumours) and CNV and in treatment some AMD cases.

TTT, relies on heat generation from en‐ dogenous pigment (hyperthermia princi‐ ple) for the treatment of Ocular Tumours and Choroidal Neovascularization (CNV).

Transscleral Cylcophotocoagulation (also known as TSCPC) of the ciliary processes. The ciliary body of the eye, which creates aqueous fluid, is treated with a laser to decrease production of aqueous. TSCPC has been demonstrated to be a safe and highly effective method for low‐ ering intraocular pressure (IOP) in pa‐ tients with severe uncontrolled glaucoma where previous medications and treat‐ ments have not shown to be effective.

The infrared 810nm wavelength is the versatile alternative in deep penetration.

Wavelength Benefits:

  • Highly absorbed by the melanin present in the Retinal Pigment Epithelium
  • Well absorbed by haemoglobin

Clinical Assets: 

  • Good transmission through haemorrhages and vitreous opacities
  • Good penetration through sclera

Main Clinical Applications

Retinal Photocoagulation

  • Diabetic Retinopathy
  • Central serous chorio-retinaopathy
  • Diabetic Macular Edema
  • Central/Branch Retinal Vein Occlusion
  • Retinopathy of Prematurity (ROP)
  • Retinal Tears, Holes, and Detachments
  • Endophotocoagulation

Glaucoma

  • Cyclophotocoagulation
  • Laser Trabeculoplasty
  • Laser Iridotomy
  • Peripheral Iridectomy
  • Sub-Threshold Photocoagulation Laser Trabeculoplasty (spLT)

Ocular Tumors

  • Transpupillary Thermo-Therapy (TTT)
Accessories and Delivery Systems
LIO
LIO
Mobile Cart
Mobile Cart
Endoprobes & G-Probe
Endoprobes & G-Probe
Remote Control
Remote Control
Downloadable Files
LIGHTLas TruScan

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