My background is in anterior and vitreoretinal surgery – and I specialize in pediatric vitreoretinal surgery, with a particular interest in retinopathy of prematurity (ROP). I have been using a range of different laser equipment in this work; for vitreoretinal surgery, I had regularly used a PASCAL and a photocoagulator laser incorporated into the Constellation from ALCON. And for laser treatment of ROP or other pediatric vascular retinal diseases, I used a Quantel Medical Vitra LIO laser.
Major laser woes
Unfortunately, we had a laser break down just as we needed to perform treatment on the avascular retina of a premature child with progressive ROP. Although we tested the laser before the general anesthesia was administered as usual, it didn’t work when we tried to start the treatment. Apparently, the laser had a probe issue, which meant the child needed to have the treatment rescheduled.
This was far from ideal and was a great source of stress and anxiety for all involved. But the response from Norlase was fantastic. We immediately sent the order out to purchase the LION laser on the morning of the failed surgery – also explaining the need for haste on this occasion. The laser was delivered the very next day with time for us to prepare and perform the surgery at lunch time. A 24-hour turn around for equipment like this is absolutely fantastic and a testament to Norlase customer service.
We chose the LION because the laser is fully incorporated into the binocular ophthalmoscope – a major advantage, as it allows us to easily move around the eyes of the children without need to adjust the light, laser beam and so on. In fact, it’s perfect for treating small children. More typically, a LIO device is on top of an existing binocular ophthalmoscope, which makes the alignment of light and laser beam less stable than we’d prefer, but with the compact design of the LION this simply isn’t an issue! This significant advantage, along with the wireless control and the battery being out of the way in the foot switch, are all reasons why I would recommend using a LION device to other retina specialists.
Light at the end of the laser
Laser failures can and do happen, but it was fantastic that we were able to carry on with the procedure 24-hours later. Bearing in mind this was a new system – it’s perhaps even more remarkable; fortunately, I was able to familiarize myself with the equipment and its functionality – and start using it – in five minutes. But the LION isn’t just easy to use – the laser treatment went perfectly, with a good outcome from the surgery.
We not only use the LION on a weekly basis for ROP treatment, but also for other pediatric vascular retinal diseases, such as Coats, thanks to its child-friendly nature. But we don’t limit the device to pediatric cases; we also use the device for panretinal photocoagulation (PRP) in cases of diabetes or for other adult retinal vascular diseases when regular pattern photocoagulation is not possible. Although we haven’t used the device for much more than this – only three other cases – we really like that the laser reduces treatment time.
This LION doesn’t bite
What pearls of wisdom can I offer retina specialists who are thinking of switching to LION? First, learn how to perform an examination using a binocular ophthalmoscope when the patient is laying down on a bed, and then do it with indentation. When these both work well for you, you’re ready to start using the LION.
Finally, I’ll add that the customer service was fantastic – and I want to reiterate just how user-friendly the LION is. For me, having a completely cable free device is the best option ever.
