LUMENIS SELECTA - Precautions

Iridotomy—1064 nm Nd:YAG  115
Selecta
PBL200051, Rev J
• patients with a bleeding tendency (as with hemophilia or those
receiving anticoagulant therapy) are at increased risk of bleeding
Precautions
Targeting
Focus the unit in accordance with the description provided in the Operation
section of this manual. Unlike other lasers commonly used in ophthalmology
(argon, krypton, and dye lasers) which rely on thermal effects, the 1064 nm
Nd:YAG laser is a cutting or disrupting instrument capable of damaging any
tissue or structure on which the beam is focused. Therefore, the Nd:YAG laser
should only be focused on target tissues and care should be used to avoid
exposure of all adjacent tissues and structures.
The diode aiming beam focus spot is longitudinally offset up to a maximum
of 350 microns in front of the Nd:YAG beam. This offset is adjusted on the
laser using the posterior offset control. With the offset control set at
100 microns, Selecta delivers a preset offset equal to 100 microns in air.
Energy
Minimal effective energy and minimal pulses per burst should be used to
reduce risk of damage to nontarget areas. In animal studies, the use of higher
total energy, larger numbers of pulses, and more pulses per burst have been
associated with an increased risk of damage to the lens. Lens damage has been
reported clinically in human eyes that have undergone Nd:YAG iridotomy.
Adverse effects
The following adverse effects and complications have been observed in
patients who have undergone Nd:YAG iridotomy:
• transient elevated IOP
• hyphema
• corneal injury (including damage to the endothelium, stroma or
epithelium)
• anterior chamber reaction (including flare, cells, and debris)
• transient blurred vision immediate postoperative
• minor, transient, pupillary distortion
• corneal edema
• transient bleeding from the iridotomy margin
• closure of iridotomy over time
• damage to the lens (perforation, rupture)