As the world’s population ages, retinal disease, glaucoma and cataracts are expected to correspondingly increase in prevalence, and access to ophthalmic laser treatments is growing around the world. Market Scope estimated in July that 2017 global revenues for ophthalmic lasers and related accessories and maintenance would reach $422 million, and that laser sales would comprise 63 percent of that total, while another 22 percent would be related to maintenance and 11 percent would go toward single-use endoprobes.1 The latter half of the year saw two new photocoagulator lasers and a new software package and hardware upgrade for a femtosecond laser all receive FDA 510(k) clearances. Here’s a brief snapshot of each of these newcomers.

Easyret Photocoagulator
This 577-nm yellow laser by Quantel (Clermont-Ferrand, France) received FDA clearance in late July 2017. The manufacturer’s proprietary ELBA fiber laser cavity forms the Easyret’s resonator; the laser delivers a 577-nm yellow wavelength in a uniform tophat spot profile to treat ocular diseases such as chronic
Quantel says that the Easyret is a low-maintenance, ergonomic alternative to solid-state lasers.
central serous chorioretinopathy, diabetic retinopathy, diabetic macular edema, branch retinal vein occlusion and associated macular edema; choroidal neovascularization; and retinopathy of prematurity. The Easyret is also indicated for trabeculoplasty in open-angle glaucoma and iridotomy in angle-closure glaucoma.

The manufacturer claims that the Easyret’s size and ergonomic setup make it a suitable, durable alternative to solid-state lasers. The Easyret is available with either a Haag Streit- or Zeiss-type slit lamp.

A large touch-screen interface lets users program the appropriate power, pulse, duration, spot size, and treatment beam intensity level for the therapy at hand:

SingleSpot treatment mode: Traditional focal photocoagulation in one spot, in single, repeat, painting or continuous-delivery modes.
MultiSpot treatment mode: Multiple consecutive laser spots treated automatically per a preselected customizable treatment pattern (square, macular grid, triple arc, circle or single spot).
SubLiminal treatment mode: The manufacturer’s proprietary subthreshold micropulse setting divides energy delivery into pulse envelopes with fully customizable on/off durations per laser shot. The company says this affords a high level of control over the thermal effect on targeted tissue.

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PASCAL Synthesis TwinStar Laser
In October 2017, Topcon (Livermore, Calif.), announced that the latest addition to its line of PASCAL (PAttern SCAnning Laser) technology, the PASCAL Synthesis TwinStar Ophthalmic
Topcon’s newly-cleared TwinStar laser combines a
638-nm red module with a 577-nm yellow laser module for treatment versatility.

Laser Scanning System, received 510(k) clearance from the FDA. The Synthesis TwinStar is an update on its predecessor, the green/yellow Synthesis. The TwinStar combines a 638-nm red wavelength module with a 577-nm yellow one to treat anterior- and posterior-segment ocular pathologies using focal or scattered photocoagulation.

The newly incorporated red wavelength is intended for targeting the choroid with single-spot treatments. Spot diameters can be set at 50 or 200 µm. The yellow wavelength is intended to perform single-spot photocoagulation in the posterior segment (retina, choroid) as well as pattern-scanning photocoagulation in the non-macular retina. It has settings for single-spot treatment, four spot sizes and a selection of patterns.

The TwinStar also incorporates the Synthesis’ proprietary optional Endpoint Management software for use with the 577-nm yellow module. Endpoint Management allows the user to titrate laser delivery at subthreshold energy levels. This application may help minimize collateral tissue damage in patients who require multiple laser treatments, and may help surgeons and patients feel more comfortable about initiating treatment earlier in the course of disease by helping to limit the potential for cumulative damage.

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Victus Femtosecond Laser 3.3 Software
Bausch + Lomb (Bridgewater, N.J.) recently got 510(k) clearance from the FDA for a new software package and some hardware modifications for its Victus femtosecond laser that the company hopes will enhance its utility and ease of use in the OR.

The Victus is an Nd:glass solid-state laser in a console that has a computerized interface for the user, and a proprietary Verafit patient interface that keeps the eye still and cornea flat to help the anterior capsulotomy go smoothly and safely. The Victus generates sub-picosend pulses that repeat at 15 kHz. The spot diameter of the beam is less than 6 µm at the target location.

The new 3.3 software platform has a centration feature to guide capsulotomy and lens fragmentation that allows
In addition to a new 3.3 software package for the Victus femtosecond laser, Bausch + Lomb has updated some ergonomic features to aid workflow.
surgeons to choose centration on the pupil, limbus, lens apex, or other location he or she selects. It also adds a grid lens-fragmentation pattern to its menu of phacoemulsification options. For refractive surgery, the 3.3 software package features automatic pupil centration to aid in making flaps. The improved platform comes with some upgrades to the Victus’ hardware, too: an S60 bed helps with workflow in the OR by swinging out farther away from the laser so that patients can get in and out more easily.  

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1. Market Scope press release. Ophthalmic lasers expected to generate $422 million in 2017. July 6 2017. Retrieved October 25 2017.