FOCUS ON …
True Yellow Laser Increases Patient Comfort
Samantha Stahl, Assistant Editor
While some surgeons fear that compact packaging means compromised quality, Christopher Riemann, MD, of Cincinnati, insists that Iridex's IQ 577 laser is the “little laser that could.”
He thinks back to the bulky lasers of decades past and the inconvenient electrical setups of tri-wavelength laser units from less than 10 years ago and is immensely satisfied to have found a versatile table-top unit that performs just as well as devices 10 times the size.
Before using the IQ 577, Dr. Riemann was using a tri-wavelength laser and found himself increasingly migrating to the yellow wavelength for all laser procedures because it did everything he needed.
“Because the yellow wavelength is not taken up by macular xanthophyll pigment, you can feel a little more comfortable doing very precise perifoveal laser treatment in diabetics.” He adds that because the yellow wave length is longer than green and penetrates vitreous hemorrhage more effectively, he rarely switches over to krypton red or diode anymore. He now uses the IQ 577 for all focal, focal destruct and focal wall-off lasers and all panretinal photocoagulations.
He appreciates the laser's reliability without having to worry about the tradeoffs of going to a green wavelength. Being able to perform a complete PRP with a yellow laser has created markedly less discomfort for the patient, he says. “In the past, I would commonly use a retrobulbar block (RBB) to achieve acceptable patient comfort levels during PRP. With the IQ 577 and very short-duration pulses, RBBs are few and far between — less than 5% of my PRPs.”
Dr. Riemann mentions a recent encounter with a very frail, wheelchair-bound, cachectic 80-year-old woman who weighed only 78 pounds, with a cardiac ejection fraction of 12. “She was in agony and vomiting because of neovascular glaucoma. To be able to do a single-session panretinal photocoagulation of 2100 spots and definitively control her neovascular glaucoma — without her even having to get out of her wheelchair and experiencing only mild discomfort — was clearly in this patient's best interest.”
The IQ 577 offers improved patient comfort for common procedures such as PRP.
SOLID STATE PERFORMANCE
Dr. Riemann jokes that, “This laser is like the Energizer Bunny — it just keeps going and going,” but he means what he says. He states that the stability is so high for panretinal photocoagulation that his standard settings are approaching near-micropulse levels. His usual PRP settings are set at a duration of 30 ms, power of 400 ms and a repeat rate of 30 ms. Using the laser indirect ophthalmoscope, he can place over 1500 spots of 360-degree PRP very efficiently. Although the system does offer a micropulse setting, Dr. Riemann has yet to use it, which he attributes to the wide scope of features that he soon anticipates exploring.
He found no learning curve with the device, and could “plug and play” immediately for most laser functions. “Two intuitive and user-friendly control panels make switching to this laser a breeze,” he says. As with any recently purchased instrument, he says there is a small learning curve when it comes to exploring the new capabilities. “I don't think I've realized the full potential of this laser yet.”
The system also features a wireless foot pedal control with power-adjust capability and audible confirmation of adjustments. An eye safety filter system allows the use of a red-free filter on the slit lamp during treatment to enhance visibility.
Most importantly, Dr. Riemann says, “The IQ 577 has simplified and improved the efficiency of laser clinics dramatically.” RP
For more information, visit www.iridex.com.