Iridex’s Pattern Scanning Laser (Pascal) system was designed to overcome the limitations of existing laser technologies. The Pascal platform provides an advanced technology package that combines fast and precise pattern scanning capabilities, endpoint management technology, pattern scanning laser trabeculoplasty, and micropulse technology in an optimized and integrated laser platform that is half the size of its predecessor, says Steve Koufos, vice president of marketing at Iridex.

The next-generation Pascal laser system has numerous clinical applications. It can perform millisecond pulse duration photocoagulation treatments such as panretinal photocoagulation (PRP) for proliferative diabetic retinopathy or other causes of retinal neovascularization; laser retinopexy for retinal tears; and focal laser for diabetic macular edema or cystoid macular edema with branch retinal vein occlusion, says Yannis M. Paulus, MD, FACS, a retinal surgeon at Kellogg Eye Center in Ann Arbor, Michigan, who performed research on an earlier version of the Pascal and now uses the current version. It can also be used in glaucoma laser treatments for pattern scanning laser trabeculoplasty.

HOW IT WORKS

Iridex’s patented MicroPulse technology works by delivering laser energy in a pulsed manner, allowing tissue to cool between pulses and reducing the risk of thermal damage to surrounding tissue. “By decreasing thermal damage adjacent to laser treatment areas, minimal tissue damage is incurred,” says Jorge I. Calzada, MD, FACS, CEO and founder of Deep Blue Retina in Memphis, Tennessee, who uses the devidce at his practice. “Treatment is localized to only the intended areas.”

Pattern scanning laser trabeculoplasty provides a rapid, precise, and minimally traumatic computer-guided treatment that applies a sequence of patterns onto the trabecular meshwork. Endpoint management is a pattern subthreshold retinal laser therapy that uses a unique algorithm to control laser power and pulse duration, optimizing the therapeutic effects of the laser at subvisible levels.

Dr. Paulus prefers the tissue-sparing treatment options when treating the macula to reduce scotomas, scarring, and other side effects while ensuring that patients have effective treatments. “I engage patients in discussions, and together make a decision for a tailored treatment plan that is unique for each patient,” he says.

“By providing the ability to create customizable treatment patterns, the Pascal laser system offers tailored treatment options for individual patients,” Koufos says. “This allows clinicians to adapt the laser treatment to each patient’s specific needs, which optimizes a procedure’s overall effectiveness.”

ADVANCED AND INNOVATIVE

According to Dr. Paulus, the pattern scanning Pascal treatment allows for the rapid application of laser spots. This reduces treatment time and often makes it possible to complete a full PRP treatment in 1 session, which improves patient adherence and clinic flow. For patients, the shorter pulse duration results in less pain, less surrounding retinal damage, and greater satisfaction.

Furthermore, nondamaging macular therapy reduces the side effects and scarring that can occur with more intense macular treatments. In addition, the system’s unique 4-fiber delivery system results in a more uniform spot with less variability, Dr. Paulus says. The integration of nondamaging macular treatment also provides an effective therapy for patients while reducing the side effects and permanent scarring that can occur with more intense millisecond conventional focal laser treatments.

“Particularly since COVID, many patients have liked the ease of administration and longer duration of tissue-sparing laser therapy over other options such as frequent intravitreal anti-VEGF injections,” Dr. Paulus says.

EASE OF USE

The Pascal laser was designed with user-friendliness and ergonomics in mind, Koufos says. It features an intuitive interface that simplifies operation and streamlines treatment workflow. The system offers customizable treatment settings, enabling clinicians to tailor treatments to individual patient needs. Additionally, ergonomic considerations, such as adjustable working positions and improved ADA-compliant wheelchair accessibility, contribute to overall user comfort and ease of use.

This system has allowed Dr. Paulus to integrate lasers more readily into the retina clinic flow. Previously, he scheduled laser procedures at the end of the clinic day, because they took a long time. In addition, patients were uncomfortable afterward and he didn’t want that to alarm others in the waiting room. “The laser’s improved comfort and speed has allowed me to integrate lasers throughout my clinic day in a seamless fashion, giving patients more flexibility in scheduling and arranging their needed laser treatments,” he says.

For Dr. Calzada, the ability to have a single laser platform for most retinal disorders, from the peripheral retina to the macula and even trabecular meshwork, is a great option for his clinics and patients. He adds, “Any treatment that can control disease long-term will benefit patients.”

Koufos concludes that the laser’s versatility and precision make it suitable for both routine and complex cases, offering physicians a valuable tool to manage retinal pathologies. RP