One of the main treatment pillars for ophthalmic complications of diabetes and venous circulatory disorders is fundus laser treatment. The Navilas laser system is one of the most advanced representatives of retina lasers also capable of micropulse mode.
In what diseases is retinal laser treatment recommended?
The Navilas laser is most commonly used in the following cases:
• diabetic macular edema (DME) *
• subretinal fluid due to central serous chorioretinopathy (CSCR) *
• macular edema due to branch retinal vein occlusion (BRVO) *
• to stop neovascularisation due to diabetic retinopathy or retinal vein occlusion (panretinal photocoagulation)
• targeted treatment of leaking macular microaneurysms in diabetic maculopathy (focal laser treatment)
• treatment of peripheral retinal tears to prevent retinal detachment
* in micropulse mode
Laser treatment can be used alone or as an adjunct to injection therapy to reduce the number of injections in case of macular edema due to diabetes or retinal vein occlusion.
Why is the Navilas laser system different from other devices?
Accuracy and reliability: thanks to its eye movement tracking system, the laser beam always acts where it is aimed; treatment is stopped immediately if the treatment plan is not visible (eg. during blinking or if the patient looks away).
Speed: thanks to the pre-prepared treatment plan, the laser foci can be placed practically continuously during the specific treatment and in contrast to the traditional one, there is no need to stop and re-evaluate the treatment regularly, thus significantly shortening the treatment time.
Convenience: the non-contact mode, the speed of the treatment plan, the lower sensitivity due to lower parameter settings and the lower light sensitivity thanks to the use of infrared light makes the procedure significantly more comfortable for the patient.
Documentation and integration: the device automatically saves every detail of the treatment, the photos of the retina before and after the treatment, the treatment plan and the applied parameter settings are all included in the report. Thanks to the possibility to import third party recordings (OCT, angiography), the accuracy of the treatment can be further increased and customized.
The Navilas laser system operates in two modes
1. Subthreshold mode
A modern, tissue-sparing method of retinal treatment is the micropulse laser therapy, which achieves the desired effect without tissue damage, which is why it is also called subthreshold or soft laser treatment.
Conventional lasers cause scarring on the retina after the treatment, scars which further increases over time to one and a half times of the applied laser foci size. For this they are applied at a distance from eachother.
In contrast, the new generation micropulse lasers does not cause heat damage to the tissue, does not lead to retinal scarring and thus the treatment can take place in the entire sick area without damaging the cells.
These advantages are particularly important when the treatment is performed in the area of the retina which is responsible for the visual acuity, such as in the treatment of macular edema or subretinal fluid accumulation.
2. Suprathreshold mode
In addition to the micropulse mode, the device is also suitable for treatment in suprathreshold mode corresponding to conventional laser treatment, but which has the following advantages:
• due to lower parameter setting (20ms instead of 100ms), the patient’s pain is significantly reduced when performing a panretinal photocoagulation (PRP) or peripheral laser treatment for retinal tears
• thanks to the eye movement tracking system, macular microaneurisms which causes fluid leakage can be treated in a targeted and safe manner with just a few spots.