Highlights

Raman Shifting Technology: The Opto Mitra™ is the first ophthalmic yellow laser that utilizes Raman Shifting technology to generate the yellow wavelength, at 586nm. The advantages of the Raman Shifting technology are that it provides superior power output, stability and reliability compared to other contemporary technologies meaning safer and more effective treatment.

Increased Efficiency and Safety with the Yellow Laser

• The 586nm yellow wavelength has high absorption by oxyhemoglobin so the Opto Mitra™is more effective when treating vascular structures in the eye.
• Yellow light results in less thermal spread, functional damage and scar enlargement (1).
• With a high oxyhaemoglobin/melanin absorption ratio, treatment better targets deep vascular structures and not pigmented tissue in the outer retina, allowing safer treatment in the macular region.
• The yellow wavelength shows negligible absorption by macular xanthophylls, the main pigment present in the macula, increasing safety margins for macular treatment.
• Because the Opto Mitra™ Yellow Laser exhibits low light scattering in intraocular transit, treatment is more accurate with superior transmission though opacities and enhanced tissue targeting. Also as a result of low light scatter, less power is requiredto achieve the same therapeutic effects as conventional green laser photocoagulation so patient pain and discomfort is reduced (2).
• Good lesion visibility means the dosage can be easily adjusted.
• In addition to the ability to safety treat areas around the macula, the Opto Mitra™ Yellow Laser can be used for all green laser procedures.
• The Yellow laser provides a more consistent effect in patients with light or irregular fundus pigmentation, with laser light absorption variability reduced by 15% (3).

Superior Ergonomic Design: The Opto Mitra™ has been designed with convenience and ease of use in mind. Intuitive design allows for reliable and single-handed operation of the system.

• Precision micromanipulator for easy and accurate positioning of the laser beam. The unique safe stop mechanism provides superior safety against shots on the macula by stopping in position if inadvertently released.
• The 5.6” Colour LCD touch screen display and backlit illuminated rotary buttons allow visibility and adjustment of the controls in all ambient conditions, so the system is simple and easy to operate with precision and speed every time.
• Robust and durable design for reliable operation and increased longevity
• Foot pedal for treatment power adjustment

Micro Pulse Photocoagulation: The Opto Mitra™can be used in the micro pulse mode to deliver trains of short pulses, enhancing treatment flexibility. Micro pulse (sub-threshold) photocoagulation offers significant clinical advantages compared to conventional continuous wave lasers, preventing laser induced thermal retinal damage and related treatment side effects.

The Opto Mitra™ is not FDA approved. This product is not for sale in the USA.

Clinical Applications

• Proliferative Diabetic Retinopathy;
• Diabetic Macular Edema;
• Occlusion of the branches and central retinal vein
• Occlusion of the branches and central retinal artery;
• Choroidal Neovascularization (CNV);
• Drusen (AMD);
• Retinal tear and detachment;
• Open-angle glaucoma and
• Closed-angle glaucoma.

Additional Information: Micro Pulse Photocoagulation

The Opto Mitra™ can be used in the micro pulse mode to deliver trains of short pulses, enhancing treatment flexibility. Micro pulse (sub-threshold) photocoagulation offers significant clinical advantages compared to conventional continuous wave lasers, preventing laser induced thermal retinal damage and related treatment side effects.

• Clinical research has demonstrated that the therapeutic effect from conventional continuous wave photocoagulation arises from the biological activity generated by non-lethal elevation of temperature adjacent to the target area rather than from the necrosis induced by thermal damage. Therefore, it is possible to achieve the benefits of laser photocoagulation without the visible burn and the associated side-effects, pain and risks (such as inadvertent foveal burns, choroidal neovascularization, pre- and subretinal fibrosis, and expansion of laser scars) that may lead to immediate and late visual loss.
• Micro pulse settings prevents the appearance of any burn mark, which signifies cell necrosis, producing a favourable benefit-to-risk ratio and optimum treatment outcomes.
• Micro pulse photocoagulation is painless and increases the clinical safety margins 10-fold over continuous wave lasers with reduced power and fewer post operative side-effects (4).
• The isolation of heat generated at the RPE in micro pulse photocoagulation allows treatment of lesions much closer to the Fovea.
• Retinal and glaucoma diseases can be treated at a much earlier stage, improving patient vision outcomes.
• Micro pulse photocoagulation can be repeated as necessary over time, due to the reduced laser-induced retinal damage.

Micro Pulse Retinal Applications

Micro pulse photocoagulation technology offers novel approach to treatment of numerous retinal disorders with greater safety margins and no known side effects.

1. It has been shown that micro pulse pan retinal photocoagulation can be used to treat high-risk non proliferative and proliferative diabetic retinopathy whilst minimizing retinal damage and treatment complications (5).
2. Low-intensity, high-density micro pulse photocoagulation can reduce or eliminate clinically significant diabetic macular edema (6), and is equally as effective as conventional green laser photocoagulation with fewer laser scars present after 12 months (7). It has also been shown that micropulse photocoagulation can improve visual sensitivity, where modified ETDRS laser photocoagulation decreases sensitivity (8).
3. Micro pulse photocoagulation is an effective treatment in chronic Central SerousRetinopathy with the potential to improve visual acuity with no laser burns and no leakage (9).

Accessories

Slit Lamp Adapter: Fits most slit lamp brands and models.

• Precision micromanipulator for easy and accurate positioning of the laser beam. The unique safe stop mechanism provides superior safety against shots on the macula by stopping in position if inadvertently released.
• Clear safety filter with low chromatic distortion enables excellent view of the retina
• Parfocal zoom, spot sizes are continuously variable from 50µm to 600µm

Laser Indirect Ophthalmoscope:

• Spot size control
• Indicated for Retinopathy of Prematurity
• Excellent for photocoagulation in the far periphery
• Ideal for treating patients in supine position
• Crustal clear safety filter for enhanced view
• Sealed optics for increased protection

Endo Ocular Probes:Straight, curved, aspirating and illuminating

• Indicated for all endophotocoagulation procedures, retinal tears and detachments
• Standard SMA connector and a range of delivery device Auto keys provide flexibility of choise of aser probe manufacture

Automatic Safety Filter: Motorized filter available for different models of Opto Zeiss, Topcon, Leica and other brands.

References

1) True Yellow 577 for the Treatment of Retinal Disorders: Searching for the Holy Grail. Robert P. Murphy. Insert to Retina today, April 2010.

2) Wavelength selection in macular photocoagulation. Tissue optics, thermal effects, and laser systems Martin A. Mainster, American Academy of Ophthalmology. Volume 93, Issue 7, Pages 952-958 (1 July 1986)

3) Continuous-wave and Micropulse 577nm Yellow Laser Photocoagulation: A Laser for all reasons. Martin A. Mainster, Insert to Retina today, April 2010.

4) Desmettre, Thomas J. Et al, Br J Ophthalmol. Doi: 10.136/bjo.2005.086942

5) Subthreshold diode micropulse panretinal photocoagulation for proliferative diabetic retinopathy. Luttrull JK, Musch DC, Spink CA. Eye (2008) 22, 607–612.

6) Serial optical coherence tomography of sub threshold diode laser photocoagulation for diabetic macular edema. Luttrull, JK; Spink, CJ. Ophthalmic Surg Lasers Imaging 2006; 37: 370.

7) Prospective randomised controlled trial comparing sub-threshold micropulse diode laser photocoagulation and conventional green laser for clinically significant diabetic macular oedema. Figueira J, Khan J, Nunes S, Sivaprasad S, Rosa A, de Abreu JF, Cunha-Vaz JG, Chong NV Br J Ophthalmol. 2009 Oct;93(10):1341-4.

8) Vujosevic S, Bottega E, Casciano M, Pilotto E, Convento E and Midena E. Microperimetry and fundus autofluorescence in diabetic macular edema: subthreshold micropulse diode laser versus modified early treatment diabetic retinopathy study laser photocoagulation.  Retina 30(6):908-16 (2010)

9) Maia, A. Micropulse Treatment for Central Serous Retinopathy. Insert to Retina Today, April 2010.
 

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