Focal and panretinal photocoagulation with a navigated laser (NAVILAS®)

Kernt, Marcus; Cheuteu, Raoul; Vounotrypidis, Efstathios; Haritoglou, Christos; Kampik, Anselm; Ulbig, Michael W.; Neubauer, Aljoscha S.

doi:10.1111/j.1755-3768.2010.02017.x

Cited by 51 publications

(41 citation statements)

References 4 publications

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“…20,24 From the physician's perspective, first-time users may view the careful treatment planning as an additional labour burden, while they have patients waiting. Planning, however, shortens the actual treatment time and retreatments are minimized for an overall much more efficient therapy.…”

Section: Navigated Laser Therapymentioning

confidence: 99%

“…Navilas integrates fundus imaging, including true-colour and FA with computer-based imageguided retinal laser therapy. 20 Both digitally planned treatments and navigated pattern laser treatments can be performed to completion at high accuracy. 20 Navigated treatments in the posterior pole are typically performed using the system planning features.…”

Section: Navigated Laser Therapymentioning

confidence: 99%

“…20 Both digitally planned treatments and navigated pattern laser treatments can be performed to completion at high accuracy. 20 Navigated treatments in the posterior pole are typically performed using the system planning features. The individual treatment plan is typically drawn on a Navilas colour image or FA that can be co-registered with external images.…”

Section: Navigated Laser Therapymentioning

confidence: 99%

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Navigated Laser Therapy for Diabetic Macular Edema

Kernt¹,

Ulbig²,

Neubauer³

2014

US Ophthalmic Review

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Retinal vascular disorders are commonly found in ophthalmologic practice: in addition to hypertensive changes and retinal vein occlusions, diabetic eye disease plays a major role. Driven by demographic change and the obesity trend, the prevalence of diabetes has increased steadily recently and is likely to rise further. Diabetic retinopathy (DR) and diabetic macular edema (DME) are ocular complications of diabetes, where numbers are expected to double by 2030.1 As opposed to other retinal diseases, DR and DME frequently affect the working-age population, requiring long-term disease management. To date, DR and especially its manifestation DME is the main cause of severe visual impairment and blindness. [1][2][3][4] For many years, laser photocoagulation has been the mainstay in the treatment of proliferative DR (PDR) and DME. 5,6 For PDR panretinal laser photocoagulation (PRP) is the method of choice to repress neovascularization caused by retinal ischemia and to prevent serious complications. Likewise, for DME without foveal involvement focal laser has been the gold standard for the last 3 decades. 6,7 The concept of clinically significant macular edema (CSMO) was introduced by the Early Treatment Diabetic Retinopathy Study (ETDRS), describing a thickening of the retina and/or hard exudates within a distance of 500 µm from the fovea or a zone of edema greater than one disk area at a distance of one disk diameter of the fovea. 6 Even though the patient still has good vision, immediate action is warranted. Numerous studies have shown that a significant stabilization of visual acuity can be achieved in patients with CSMO by a single or repeated focal laser treatment. 3,4,7 While the exact mechanisms of action of laser photocoagulation in DME (focal or modified grid laser photocoagulation) are not fully understood, it seems clear that extensive tissue scarring is not the primary aim as it is in laser retinopexy or panretinal laser treatment for PDR. It has been postulated that a major goal of macular laser therapy is to solve leakage arising from macular vessels by photocoagulating photoreceptors and it is believed that, in macular laser treatment, photocoagulation of photoreceptor outer segments results in sealing of the blood vessels in the area of highest visual acuity and the subsequent reduced oxygen demand of the outer retina helps reduce retinal hypoxia. [8][9][10] In addition, increased oxygen tension in the inner retina helps to decrease tissue edema and improve vision by autoregulatory vasoconstriction and reduced hydrostatic pressure in the capillaries and venules. 8,10 With a delayed onset-of-action, treatment success after macular laser photocoagulation can be assessed at the earliest 3 months after the therapy session.11 Three to four treatments are typically required when using a slitlamp-based, manually applied laser to achieve stabilization of vision.11 On average, only limited visual gains can be expected. 6 Over the years, the original ETDRS laser protocol was steadily adjusted and improved, leadi...

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Section: Navigated Laser Therapymentioning

confidence: 99%

Section: Navigated Laser Therapymentioning

confidence: 99%

Section: Navigated Laser Therapymentioning

confidence: 99%

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Navigated Laser Therapy for Diabetic Macular Edema

Kernt¹,

Ulbig²,

Neubauer³

2014

US Ophthalmic Review

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“…in a recently published study, patients reported a consistently lower level of therapy discomfort versus conventional laser, owing to faster treatments after pre-planning as well as the reduction of glare by infrared illumination and the omission of the contact glass in most treatments. 20,24 From the physician's perspective, first-time users may view the careful treatment planning as an additional labour burden, while they have patients waiting. planning, however, shortens the actual treatment time and retreatments are minimised for an overall much more efficient therapy.…”

mentioning

confidence: 99%

“…this greatly benefits teaching and for the first time enables telemedicine: a plan can be e-mailed to another expert for review and applied later with or without revisions. 20,[25][26][27] Panretinal and Sectoral Laser Therapy with the Navilas Laser System the introduction of a wide-field objective and custom contact lens has opened the system for navigated treatments of the far-periphery (see Figure 3). the dynamic field-of-view matches conventional lasers.…”

mentioning

confidence: 99%

Navigated Laser Therapy for Diabetic Macular Oedema

Kernt¹,

Ulbig²,

Neubauer³

2013

European Ophthalmic Review

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Navigated laser therapy introduces computerised assistance systems to retinal laser photocoagulation treatment. As main benefits over conventional laser, the Navilas system offers high precision and safety and provides additional advantages regarding standardisation of planning, execution, documentation, quality assurance and better overall treatment comfort for the patient. Navigated laser therapy is being used with good success in the treatment of diabetic macular oedema (DMO), retinal vein occlusions (RVO) and fast-pattern navigated panretinal photocoagulation in proliferative diabetic retinopathy (PDR). In centre-involving DMO, a combination of anti-vascular endothelial growth factor (VEGF) and macular laser may provide advantages over anti-VEGF monotherapy. In terms of navigated laser therapy, recent study data from our clinic and other institutions indicate that combined initial anti-VEGF and navigated macular laser therapy allows treatment success to be achieved and maintained with a significantly reduced number of interventions. KeywordsDiabetic retinopathy, macular oedema, ETDRS, navigated laser therapy, pattern laser, diabetes 1 As opposed to other retinal diseases, DR and DMO frequently affect the workingage population, requiring long-term disease management. To date, DR and especially its manifestation DMO is the main cause of severe visual impairment and blindness.

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Retinal Laser Telephotocoagulation and Teleeducation

Kozák¹

2023

Retina Lasers in Ophthalmology

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Focal and panretinal photocoagulation with a navigated laser (NAVILAS®)

Cited by 51 publications

References 4 publications

Navigated Laser Therapy for Diabetic Macular Edema

Navigated Laser Therapy for Diabetic Macular Edema

Navigated Laser Therapy for Diabetic Macular Oedema

Retinal Laser Telephotocoagulation and Teleeducation

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