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MicroPulse™ Laser Therapy MicroPulse allows the tissue to cool between laser pulses, minimizing or preventing tissue damage. Treatment risks are reduced or eliminated, with increased patient comfort than with conventional, continuous-wave laser treatment. 
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MicroPulse laser therapy is a tissue-sparing solution for the treatment of retinal diseases and glaucoma. With MicroPulse, a continuous-wave laser beam is chopped into a train of tiny, repetitive, low energy pulses separated by a brief rest period which allows the tissue to cool between laser pulses. MicroPulse laser therapy also can be used in conjunction with drug therapy, allowing complete and optimized management of retinal diseases and glaucoma without laser-induced damage.
Retina MicroPulse settings extend the aspects of tissue-sparing applications to treatments otherwise performed with conventional photocoagulation. DME, CSR, and even PDR are areas where MicroPulse laser therapy can be utilized.
Learn How Glaucoma MicroPulse laser trabeculoplasty (MLT) is a tissue-sparing laser therapy intended to reduce intraocular pressure. Unlike conventional laser trabeculoplasty procedures, there is no destructive, coagulative damage to the trabecular meshwork.
Learn How
MicroPulse is a laser delivery modality that adds fine control of photothermal effects in laser photocoagulation. In conventional photocoagulation, the temperature rise for an intended intraoperative endpoint is controlled by adjusting the power and the exposure duration of the continuous-wave (CW) laser emission.
With MicroPulse, the steady CW emission is "chopped" into a train of short laser pulses, whose "width" ("ON" time) and "interval" ("OFF" time) are adjustable by the surgeon. A shorter MicroPulse "width" limits the time for the laser-induced heat to spread to adjacent tissues, thus providing fine control of energy delivered. A longer MicroPulse "interval" between pulses allows cooling to take place before the next pulse is delivered.
MicroPulse (low duty cycle). Very little thermal spread can occur due to the extended "OFF" time between each MicroPulse. Tissue is allowed to return to baseline temperature before the arrival of the next pulse.
MicroPulse (medium duty cycle). Doubling the "width" of the pulse, doubles the energy deposited, increases the heat spread during the "ON" time, reduces the cool off time, but can still avoid cumulative thermal build-up.
MicroPulse (high duty cycle). More energy is deposited with more thermal spread during the “ON” time and some thermal build-up due to the shorter cool off time before the next pulse.
CW Pulse (100% duty cycle). The thermal rise and re-equilibration can only be controlled by adjusting the power and the exposure duration of the CW laser emission.
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CombiningTissue-sparingMicroPulseTM LaserTherapyand Anti-VEGF Medication Produces Unprecedented Results in Radiation Retinopathy
Murray, MD
MicroPulse is a laser energy delivery modality that enables fine control of the thermal effects of photoco- agulation...
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Treating Chronic Central Serous Chorioretinopathy
Michael Koss, MD, FEBO
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MicroPulseTM Laser Therapy and Anti-VEGF Injections for Macular Edema Associated with CRVO
Patrick Caskey, MD
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NEW! Fovea-Friendly* MicroPulse Laser Therapy
May 2012 Retina Today Supplement.
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Tissue-sparing* MicroPulse diode laser photocaogulation in practice, Supplement to Retina Today
Multiple articles addressing physicians’ clinical experience using tissue-sparing MicroPulse laser to treat DME and macular edema secondary to BRVO.
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Subthreshold laser therapy yields good outcomes
Dr. Gossage shares his experiences using MicroPulse laser therapy to treat retinal and glaucoma disorders.
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DME - First Line Therapy - IQ 532™
Case study using IQ 532 with MicroPulse™ technology to effectively treat a 70-year-old patient with longstanding DM.
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DME Refractive to Avatin and Ozurdex - IQ 532™
Case study using IQ 532 with MicroPulse™ technology to effectively treat a 63-year-old patient with longstanding DM and PDR with DME.
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DME Refractive to 6 Injections of Bevacizumab - IQ 532™
Difficult case of diffuse diabetic macular edema who received 6 monthly injections of bevacizumab with no results.
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DME Refractive to 7 Injections of Bevacizumab - IQ 532™
Female patient with difficult case of diffuse DME who received 7 monthly injections of bevacizumab with no results.
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Diabetic Macular Edema - IQ 577™
Treatment Parameters - 577nm wavelength, 100um spot size on SLA, Macular Area Certralis contact lens, 200ms duration, 5% duty cycle
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Diabetic Macular Edema - IQ 532™
Case Report - 28-year-old male with type 1 diabetes, previously treated with argon focal/grid laser in February 2006 and July 2008.
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532 nm Subthreshold MicroPulse Effectively Reduces Diabetic Macular Edema after Failed Conventional Laser Treatment
This case involves a 75-year-old pseudophakic woman with Type 2 diabetes mellitus. Her left eye was treated in 2004 and 2008 with traditional focal laser treatment, which partially resolved her diabetic macular edema (DME).
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Diabetic Macular Edema - IQ 810™
Treatment Parameters - 810nm wavelength, 125um spot size on SLA, Mainster Macular Certralis contact lens, 300ms duration, 5% duty cycle
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Diabetic Macular Edema - IQ 577™
Case study using IQ 577 with MicroPulse™ technology to effectively treat a 69-year-old, female with Type-2 diabetes..
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MicroPulse™ Laser Therapy of DME Successful in Anti-VEGF Non-responder
Case study using IQ 577 with MicroPulse™ technology to effectively treat a DME patient without laser burns and collateral effect.
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 | | Long-term safety, high-resolution imaging, and tissue temperature modeling of subvisible diode micropulse photocoagulation for retinovascular macular edema A long-term retrospective review of 274 consecutive eyes with macular edema due to DME or BRVO that were treated with MicroPulse high density laser treatment using various duty cycles and followed for up to 10 years. Authors’ conclusions: High density MicroPulse laser treatment effectively treats retinovascular macular edema without laser-induced retinal damage Download Now
| | | Randomized clinical trial evaluating mETDRS versus normal or high-density micropulse photocoagulation for diabetic macular edema A prospective, double-masked, controlled clinical trial on 123 eyes with DME. Three dosing protocols were compared and patients were followed for a minimum of 1 year. Authors’ conclusions: High density MicroPulse treatment is superior to the mETDRS based on BCVA improvement and CMT reduction. Download Now
| | | Microperimetry and fundus autofluorescence in diabetic macular edema: subthreshold micropulse diode laser versus modified early treatment diabetic retinopathy study laser photocoagulation A prospective, randomized clinical trial on 62 eyes (50 patients) with untreated, center-involving, clinically significant DME, treated with either ETDRS or subthreshold MicroPulse laser therapy. Authors’ conclusions: High density MicroPulse laser is as effective as mETDRS laser in stabilizing visual acuity and in reducing macular edema with the benefits of no tissue damage detectable at any time point postoperatively, and of significant improvement in retinal sensitivity. Download Now |  | | Subthreshold diode laser micropulse photocoagulation versus intravitreal injections of bevacizumab in the treatment of central serous chorioretinopathy A comparative, controlled, prospective study comparing MicroPulse, intravitreal BCZ injection, and observation for the treatment of CSC in 52 eyes of 52 patients. Authors’ conclusions: Results indicate superior subretinal fluid resolution, and superior VA improvement and other visual functions, for MicroPulse laser compared to anti-VEGF injections, with no tissue reactions observed during and at any point after MicroPulse treatment. Download Now
|  | | Subthreshold Diode Micropulse Laser Photocoagulation (SDM) as Invisible Retinal Phototherapy for Diabetic Macular Edema: A Review A review of the role and evolution of retinal laser treatment for DME, including the state-of-the-art of clinically effective and harmless subthreshold diode (810 nm) laser MicroPulse photocoagulation for the treatment of DME. Authors’ summary: The discovery of clinically effective and harmless SDM treatment for DME offers exciting new information that will improve our understanding of laser treatment for retinal disease, expand treatment indications, and improve patient outcomes. Download Now
| | | Nonvisible subthreshold micropulse diode laser (810 nm) treatment of central serous chorioretinopathy. A pilot study A prospective study of 24 eyes, with CSC for more than 3 months with no prior intervention, were treated with nonvisible MicroPulse laser. Mean follow-up was 14 months (mean, range 3 to 36 months). Authors’ conclusions: The majority of eyes achieved anatomic and functional improvements. MicroPulse is a new and promising method for treating a previously untreatable disorder. This minimally invasive and retina sparing treatment may allow the cure of CSC at its earlier stages when irreversible visual loss has not occurred Download Now
| | | Micropulse diode laser photocoagulation for central serous chorio-retinopathy A retrospective case series of 5 patients with CSC treated with MicroPulse. At 17.1 months (mean, range 6 to 24 months) follow-up, 4 of 5 patients had complete resolution of symptoms. Authors’ conclusions: Outcomes confirm long-term efficacy of MicroPulse in the management of CSC. It produces therapeutic effects that appear comparable to those of conventional PC with no detectable signs of laser-induced iatrogenic damage Download Now
|  | | Tissue-Sparing Photocoagulation Bibliography Download Now |
 | | MicroPulse™ for the Ultimate Skeptic: Seeing is Believing Watch Now |  | | Workshop: Insights in the Treatment of Macular Edema using MicroPulse Laser September 2012 Watch Now |  | | Webinar: Integration of MicroPulse Laser Therapy (MPLT) in the Management of Diabetic Retinopathy May 2012 Watch Now |
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*Bhagat N, Zarbin M, Mansour S, Chong V, and Cardillo JA. Fovea-friendly MicroPulse Laser. Supplement to Retina Today, May/June 2012
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