The Nanopulse Revolution
Innovations
Ellex Satellite Meeting
8th September 2012
Milan
ALT
50 µm
514 nm
100 ms
400-600 mW
Shrinkage or Stretching
Shrinking or Stretching?
Stretching
Shrinkage
ALT
Photocoagulation
Cell Death & Scarring
OVERKILL!
Pigmented Cells
SLT
400 µm
Wavelength 532 nm
Pulse Length
3 nsec
Energy 0.6 – 1.2 mJ
Selective Damage Pigmented Cells
SLT Selective (Tissue)
SLT
Nanosecond Pulses
Selective Damage Pigmented Cells
MMPs
Immune
Response
Macrophages
Growth Factors
Apoptosis
Ischaemic Retina
Angiogenic Factors
MEYER-SCHWICKERATH G. [Experiments with light-coagulation of
the retina and iris.]. [German] [Journal Article] Documenta
Ophthalmologica Proceedings Series. 10:91-118; discussion, 119-31, 1956.
ASHTON N. STUDIES OF THE RETINAL CAPILLARIES IN
RELATION TO DIABETIC AND OTHER RETINOPATHIES.
[Journal Article] British Journal of Ophthalmology. 47:521-38, 1963 Sep
Oxygen Transfer
Wolbarsht & Landers
Wolbarsht ML. Landers MB 3rd. The rationale of photocoagulation
therapy for 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%
OXYGEN
2
2
1
1
Migrating RPE
1. MMPs
2. Cytokines
3. Immune Response
4 -7 Days
7 + Days
Argon
200 ms
320 µm
Micropulse
200 µs
20 µm
Nd:YLF
3 µm
2 µs
2 RT
3 ns
<1 µm
No
Primary Photoreceptor
cellDamage
Damage
SECONDARY
Photoreceptor
Microseconds (“Micropulse”)
No Transport Photoreceptor Death
2RT
Wavelength
532nm
Pulse duration
3 nanoseconds
Discontinuous
Beam
Distribution
Max energy
1mJ/pulse
Spot size
400 microns
Not
SLT Laser
“Photorejuvenation”
Courtesy of N Cuenca 2007
400µm spot
40µm cell
2RT
No Damage to Neural Retina
Cytokines
MMPs
Immune
Cytokines
MMPs
Response
Ultra Q
Technology Step
1.8 mJ
New Lenses
If a femtosecond was as long as one second
One second would become 32 million years
1 second
1 millisecond 10-3
1 microsecond 10-6
1 nanosecond 10-9
1 picosecond 10-12
1 femtosecond 10-15
1 attosecond 10-18
1s
0.001s
0.000001s
0.000000001s
0.000000000001s
0.000000000000001s
0.000000000000000001s
If a nanosecond was as long as one second
One second would become 32 years