The Nanopulse Revolution - SLT for Glaucoma | Ellex
The Nanopulse Revolution - SLT for Glaucoma | Ellex
The Nanopulse Revolution - SLT for Glaucoma | Ellex
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<strong>The</strong> <strong>Nanopulse</strong> <strong>Revolution</strong><strong>Ellex</strong> Satellite Meeting19 th September 2011Vienna
ALT50 μm514 nm100 ms400-600 mWShrinkage or Stretching
Shrinking or Stretching?StretchingShrinkage
ALTPhotocoagulationCell Death & ScarringOVERKILL!
Pigmented Cells
<strong>SLT</strong>400 μmWavelength 532 nmPulse Length 3 nsecEnergy 0.6 – 1.2 mJSelective Damage Pigmented Cells
<strong>SLT</strong> Selective (Tissue)
<strong>SLT</strong>Nanosecond PulsesSelective Damage Pigmented CellsMMPsImmune ResponseMacrophagesGrowth FactorsApoptosis
Ischaemic RetinaAngiogenic FactorsMEYER-SCHWICKERATH G. [Experiments with light-coagulation ofthe retina and iris.]. [German] [Journal Article] DocumentaOphthalmologica Proceedings Series. 10:91-118; discussion, 119-31, 1956.ASHTON N. STUDIES OF THE RETINAL CAPILLARIES INRELATION TO DIABETIC AND OTHER RETINOPATHIES.[Journal Article] British Journal of Ophthalmology. 47:521-38, 1963 Sep
OXYGENOxygen TransferWolbarsht & LandersWolbarsht ML. Landers MB 3rd. <strong>The</strong> rationale of photocoagulationtherapy <strong>for</strong> proliferative diabetic retinopathy: a review and a model.[Review] [65 refs] [Journal Article. Review] Ophthalmic Surgery. 11(4):235-45, 1980 Apr.10%100%90%
2 21 1Migrating RPE1. MMPs2. Cytokines3. Immune Response4 -7 Days7 + Days
Argon200 ms320 μmMicropulse200 μs20 μmNd:YLF2 μs3 μm2 RT3 ns
Photoreceptor cell Secondary DamageMicroseconds (“Micropulse”)No Transport Photoreceptor Death
2RTWavelength532nmPulse duration3 nanosecondsDiscontinuousBeamDistributionMax energy1mJ/pulseSpot size400 micronsNot<strong>SLT</strong> Laser“Photorejuvenation”Courtesy of N Cuenca 2007
400μm spot40μm cell
2RTNo Damage to Neural Retina
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