The Micropulse Yellow Laser is an innovative medical device that emits pulses of yellow light of very short duration (micro-pulses). It is used for the treatment of numerous diseases affecting the retina. It is particularly indicated for the treatment of maculopathies, the diseases affecting the macula, which is the area of the retina that provides our distinct central vision and allows us to recognize faces, read, write, appreciate colors, etc. Specifically, the Micropulse Yellow Laser proved to be decisive in significantly stopping the progression of diseases such as chronic central serous chorioretinopathy (CRSC), diabetic retinopathy with macular edema, and retinal vein thrombosis with macular edema.
If it is true that there are unfortunately no cures able to definitively restore sight to those suffering from some form of maculopathy, then the laser therapies currently available can slow down the development of the disease.
The first generation micropulse yellow laser, the one with the more traditional machines, is performed the same way as the green laser, which has the patient sit in front of the slit lamp on which the laser is mounted, the ocular surface is anesthetized with a trivial anesthetic eye drops, and a lens is put on the eye that does the interface and serves to stabilize the eye.
At this point the surgeon sees the inside of the eye, sees the retina and in a traditional, that is, as to make a traditional laser, it has a grid of spots that are inside the laser computer projected onto the retina. It has patterns that it can choose, five by five, seven by seven, three by three, that is, squares with sides of three or five or seven spots that are projected onto the retina and by programming the computer the surgeon can perform this treatment. Of course it looks very much like a traditional laser treatment.
What Differentiates The Micropulse Yellow Laser From Other Laser Treatments
The lasers used to treat retinal diseases work through the emission of a continuous green light that determines the warming of the macula. This makes them effective but also particularly invasive towards the treated ocular zone; injuries to the photoreceptor cells of the retina and the consequent formation of large “scars” which, depending on where they are positioned, can even lead to complications such as further reduction of visual acuity, visual field, color perception, night vision, and contrast sensitivity.
The Micropulse Yellow Laser, on the other hand, emits micropulses of yellow light and are of very short duration, interspersed with brief periods of rest. This eliminates the problem of overheating of affected tissues and therefore, allows the delicate central part of the macula to be treated, the fovea centralis, without the typical risks of conventional lasers such as the aforementioned damage to the visual cell layer (photoreceptors).
How The Micropulse Yellow Laser Works
By emitting ultrashort pulses (in the microsecond sequence) with a highly regulated switch, the Micropulse Yellow Laser does not create a thermal effect to “burn” the retinal cells and force the activation of the surrounding cells. In contrast, it generates scattered activation, without burns, of the cells of the underlying layer called retinal pigmented epithelium (RPE). It is a selective barrier to and a vegetative regulator of the overlying photoreceptor layer, thereby playing a key role in its maintenance.
This cellular reactivation allows for the reabsorption of the liquid build-up that causes visual impairment because it accumulates in the central retina (macula).
How To Perform A Treatment With The Micropulse Yellow Laser
The process is painless, quick, and safe. Compared to conventional lasers, treatment times are reduced and the piercing sensation that is often associated with the said lasers is greatly diminished. The patient is instilled with mydriatic eye drops to dilate the pupil and subsequently, a few anesthetic eye drops. The patient is seated in front of the laser and after the session, there may be a brief feeling of dizziness, nausea, minor annoyances that easily go away within a few minutes.
The results are apparent after a period of time that is generally longer than that of traditional lasers, usually one to three months.
Navilas micropulse yellow laser, 577 nanometers for the treatment of retinal vascular and hematologic diseases. We have a machine equipped with a different system than the traditional one we are used to, this machine needs the acquisition of a high definition photo of the patient’s retina.
So the patient sits in front to this non-contact machine, so you don’t put a lens on the eye but the machine acquires the patient’s photo without having to touch them, through this optical system. Having acquired the photo, the photo is in the database, we choose the photo that we like best. After choosing the photo of the treatment, this is a central serous choroiditis or chronic central serous choroidopathy.
You choose this small “edit plan” button, where we have the option to build the treatment, because the treatment has to be carefully constructed before it is performed. Usually with other lasers we directly perform the treatment on the retina, whereas with this type of laser we have to plan it beforehand, so photo first, then having acquired the photo we edit our treatment. We choose the type of treatment we want to do, then the pattern size, which at most goes up to five. The space between each spot must be zero, this is in common with other lasers too, the sizing of the spot: two hundred microns, the power:
three hundred millivatts; then again the spot size, again it has to be chosen, and the pulse duration: two hundred milliseconds.
These are the parameters, after which we start to draw on the retina the area we are going to treat with this system. We treat both the foveal area, the fuzz, and we extend the treatment just outside the edematous area.
This machine also has available two no-treatment areas, where the machine does not deal with and the surgeon chooses to activate it or not. After finishing the planning, we move on to the execution of the treatment, the patient sits in front of the machine, the laser recognizes the patient and basically overlays the image that we have acquired with the real image.
At this point, automatically, with an active eye tracking system (that essentially tracks the eye if it moves) it performs the laser treatment. At the end of the laser treatment, a picture can be taken to verify that a proper job has been done. This is the work that has actually been done and this is the photo that is taken at the end to verify that no damage was done. There are, in fact, no spots on the retina, so no damage was done, being an obvious sub-threshold treatment.
So we have the hypothesis that we have made now, for example, the hypothesis of the actual treatment that was performed to this patient and then the photo of the just treated eye as medico-legal evidence that no damage was done to any retinal tissue. You can also use this machine for a laser treatment of the diabetic, in the sense of a traditional laser treatment. The patterns of course are different, you have to choose a different spot spicing so a treatment closer to a traditional treatment.