LUMENIS smart532 - A.4.2. Parameters in SmartPulse

Smart532
™
Clinical Guide
UM-1151440EN, Rev. C, May 2016 A-11
In SmartPulse, the stimulus is a train of brief pulses (see Table A-2). The
characteristic use of SmartPulse is when a sub-visible tissue reaction is
requested. In such a case, power is estimated by titration done at a
peripheral retinal location: at this location, using a continuous waveform
the power is gradually increased to P
vis
, until a barely visible burn is
obtained. In SmartPulse, the power typically used is P
vis
multiplied by a
factor of 1.2 to 2.0 (see Table A-2 for references).
Because the tissue reaction is sub-visible, physicians might not recognize
if an area has been treated, leading to under-treatment (not treating an
area) or over-treatment (treating over an area which was previously
treated). Different strategies may be employed to address this issue.
For example, visible landmarks (e.g., light gray burns) obtained with
continuous waveforms could delimit an area to be treated (for example, the
corners of a square). The area within the delimited area could be then
filled with sub-visible spots.
Another possibility is for the physician to draw a treatment plan before the
actual treatment, clearly marking the fovea, the major arcades, the
arterioles and an outline of the area to be treated. During treatment, treated
areas could then be marked on the outlined areas in the treatment plan,
thereby preventing the physician from treating the same areas twice, and
indicating him which areas were not yet treated.
With gathering more experience using the system, physicians that treat in
the sub-visible range will typically adopt their own strategies.
Table A-2 lists recommended clinical treatment parameters for intended
medical conditions using SmartPulse:
A.4.2. Parameters in
SmartPulse