Norlase created the Echo green pattern laser photocoagulator to address the shortcomings of current pattern lasers on the market. According to Norlase CEO Oliver Hvidt, lasers never overcame some significant drawbacks, even though the technology debuted 15 years ago. These drawbacks include being quite large and typically weighing more than 100 pounds, having relatively complex user interfaces with features that many doctors don’t know how to use, and being expensive.

“By combining our ultracompact semiconductor laser with a novel technology for generating laser patterns, we addressed all of these issues at once,” Hvidt says. Echo is primarily used to treat conditions related to diabetic retinopathy and age-related macular degeneration, including retinal tears, macular edema, and retinal vein occlusion.

SIMPLE SETUP

Echo easily mounts on top of an existing slit lamp. This is possible by combining ultracompact laser technology with Micro-Electronic-Mechanical system (MEMS) mirrors, which is a tiny mirror mounted on a silicon substrate, Hvidt says. By using silicon’s electromechanical properties, the mirror can be manipulated rapidly and precisely with an electrical current. In comparison, traditional pattern lasers rely on multiple motorized mirrors called galvanometers, which are bulkier, more complicated, and have many more moving parts, Hvidt explains.

“Being able to mount Echo to slit lamps that we already use every day is a huge benefit,” says Paul Hahn, MD, PhD, FASRS, a retina specialist at NJRetina in Teaneck, New Jersey, who uses Echo at his practice. “The Echo allows me to take advantage of the superior optics and familiarity of my existing slit lamps.”

FEATURES

The laser photocoagulator itself has the smallest physical footprint in the industry — it can fit in the palm of your hand. Therefore, Echo can easily be moved to different exam rooms or practice locations, or even taken on long journeys, Hvidt says. In fact, the carrying case for the entire system is about half the size of a typical airline carry-on bag.

Norlase drastically reduced the number of components and moving parts in Echo, compared to traditional pattern lasers. This makes it possible to offer the device at a lower price point and also improves its robustness, Hvidt says. Both the laser module and the pattern-generating MEMS mirror have been stress-tested to millions of cycles without any degradation.

Because everything is integrated into 1 device, there’s no need for a fiber-optic cable connection, which increases its reliability and makes installation simple, Hvidt continues. The device also features specially developed optical coatings, providing the clearest safety filters of any laser system, Hvidt says. Together with a dynamic aiming beam, which gives physicians an uninterrupted view of the treatment area, Echo provides optimum visualization. Micro-second pulsing for subthreshold treatments is included.

Furthermore, the Echo has all of the benefits of Norlase’s Leaf, a compact green laser photocoagulator, and adds pattern capability with up to a 5x5 scan that pairs well with subthreshold laser capability.

“It’s incredible that these advanced features can be built into the same package,” Dr. Hahn says. Echo’s additional features expand the system’s utility and include a scatter laser with a pattern feature and a focal laser with a subthreshold feature.

“Along with its affordable price point, the system has become a very attractive option for our practice,” Dr. Hahn says.

USE IN PRACTICE

The Echo was also designed to be extremely user friendly. It connects wirelessly to a tablet and has an intuitive interface that can even be used for all of its advanced features. It also takes voice commands. Also, because it attaches easily to most slit lamps, in less than a minute, physicians can use their preferred slit lamp.

“This design gives physicians more treatment flexibility because laser treatments no longer have to be confined to a dedicated laser room,” Hvidt says. “From a clinic workflow standpoint, this means increased patient throughput. On the patient side, this results in shorter wait times for treatment.”

Dr. Hahn can attest to the benefits of Norlase’s suite of portable lasers. “If a patient needs an indirect laser, they can be treated with the untethered, laser-integrated LION indirect in their exam room without having to move,” he says. In his practice, Norlase’s slit lamp lasers, the Echo and Leaf, are mounted on portable, wheeled slit lamps, which can also be moved to a patient’s exam room. “Minimizing patient movement improves workflow and often diminishes patient anxiety over their procedure.” The familiar optics afforded by mounting the Leaf and Echo on existing slit lamps may also improve visualization of the posterior segment and therefore the ability to optimally target pathology, he adds.

THE ULTIMATE GOAL

Norlase hopes to make pattern lasers more ubiquitous, meaning that more patients will have access to treatment that is faster and more convenient, Hvidt says.

“With diabetic and elderly populations increasing, as well as an insufficient number of ophthalmologists globally, the increased burden of ophthalmic care is putting greater pressure on the dwindling number of ophthalmologists,” Hvidt says. “Putting more efficient tools into the hands of more physicians is the key to ensuring that more patients will have access to necessary treatments.” RP