Pneumatic skin flattening (PSF) is a new technology which enables painless and safer coupling of an intense
treatment laser beam into the skin with enhanced spectral selectivity. Applications are mainly in aesthetic laser and
IPL treatments. PSF generates vacuum over the skin, followed by very fast suction and flattening of the skin
against a Sapphire window. The utilization of a translucent diffusing Sapphire window considerably enhances
safety without compromising efficacy. PSF clinical advantages are: - Pain inhibition which is attributed to the "gate theory of pain transmission" whereby strong enough
"squeezing" of pressure receptors over a large area of the skin blocks the transmission of pain to the brain in the
dorsal horn. - Expulsion of blood from the treatment beam pathway. This results in a more transparent skin. - Reduced post treatment erythema and edema. - Increased distance between target and underlying structures. - Capability to increase efficacy by the increase of energy without pain.
Controlled clinical studies of pain reduction and efficacy over ~100 patients have been conducted in X6 clinical
centers. The studies confirmed the clinical advantages of PSF with high statistical significance and
repeatability. The adaptability of PSF technology to almost any laser or IPL enables the entire worldwide aesthetic
laser/IPLs install base to take advantage of this new technology.
Propionibacterium. acnes is a Gram positive, microaerophilic bacterium which takes a part in the pathogenesis of inflammatory acne. P. acnes is capable to produce high amounts endogenic porphyrins with no need of any trigger molecules. Light in the violet-blue range (407-420 nm) has been shown to exhibit a phototoxic effect on Propionibacterium acnes when irradiated in vitro. The purpose of our study was to test the clinical effects of a high intensity narrowband blue light source on papulo pustular acne. A total of 35 patients in 3 centers were treated twice a week with a high intensity metal halide lamp illuminating the entire face (20x20 cm2) or the back with visible light in the 407-420 nm range at an intensity of 90 mW/cm2 (CureLight Ltd.) for a total of 4 weeks. UV is totally cut off. In each treatment the patient was exposed to light for 8-15 minutes. After 8 treatments, 80% of the patients with mild to moderate papulo-pustular acne showed significant improvement at reducing the numbers of non- inflammatory, inflammatory and total facial lesions. Inflammatory lesion count decrease by a mean of 68%. No side effects to the treatment were noticed. In conclusion, full face or back illumination with the high intensity pure blue light we used exhibits a rapid significant decrease in acne lesions counts in 8 biweekly treatments.
Current Ruby lasers or Flashlamp light sources for non- invasive removal of unwanted hairs are limited to a treatment speed of approximately 25 cm2/minute. Although adequate for facial treatments, that speed is too slow for treatment of backs and legs. We present an 18-month study of the use of a 5 pps Alexandrite laser (755 mm wavelength) operated at 20 - 40 J/cm2. The 2-millisecond pulse duration laser was used on over 200 patients. Results show less than 5 - 10% regrowth 3 months after the last treatment in over 90% of patients. The average number of necessary full area treatments is two followed by 1 - 4 touch-ups at intervals of 11/2 - 3 months, depending on the body site. Treatment speed is 20 minutes for a back and less than 15 minutes per leg.
The ability to vaporize extremely thin layers of epithelial tissue without any char and with minimal thermal necrosis is extremely advantageous in the treatment of superficial lesions of the external genitalia. We present a novel CO2 laser `SwiftLase' flashscan technology capable of providing char free ablation of 3 mm diameter lesions with only 150 micron residual thermal necrosis depth at power level as low as 10 watts. These power levels are achievable with a small transportable CO2 laser. The SwiftLaser is a miniature opto- mechanical scanner which homogeneously covers a 3 mm diameter surface with a 0.1 mm spot size focused beam within 0.1 seconds. The instantaneous beam's dwelling time is 1 millisecond. The instantaneous power density level at the focal point is higher than the threshold for char free ablation, thus providing a large char free ablation crater. Since depth of each ablated layer is 0.1 mm, the depth of treatment can be precisely controlled. The SwiftLaser technology has extensively and successfully been used in the last two years for the treatment of HPV in female lower tracts (Vulvectomy). The same technique may be performed with extramammary Paget's disease of the vulva, penile condylomata, and other epithelial disorders of the external genitalia without damage to surrounding healthy tissue. Technique and clinical results will be discussed.
We present two different methods to treat hypertrophic turbinates in an office environment: (a) with the aid of 1 mm thin hollow waveguides transmitting a CO2 laser beam to produce char-free ablation of turbinate mucosa, and (b) with the aid of a 800 micron thin optical fiber transmitting low power Nd:YAG laser radiation to interstitially coagulate and shrink submucosal tissue. Char-free ablation of mucusal tissue: An office CO2 laser regularly used for LAUP in the treatment of snoring problems is operated in the Superpulse mode (peak power 350 W) at 8 W average power. The optical beam is coupled to angled and straight hollow waveguides. Ablation of inferior turbinates is performed within a few minutes under topical or local anesthesia. No post operative packing is required and the patient can return to normal activities. Healing is fast due to the highly controlled superficial thermal damage. Interstitial coagulation of inferior turbinates: Submucosal coagulation of tissue is attained with a flat 800 (mu) fiber longitudinally pushed and pulled while operating an Nd:YAG laser at 8 W power level. A 4 - 6 mm thin coagulated and shrunken volume of cylindrical shape is being produced with no damage to bones or mucosa. The procedure is fast and performed under local anesthesia. An analysis of both surgical techniques and clinical results with over 100 patients will be presented.
Interstitial photothermal coagulation has long been recognized as a potential important, minimally invasive modality for treating a variety of pathologic conditions. We present two different technologies for interstitial photothermal coagulation of tissue with infrared lasers: An optical fiber with a radially symmetric diffusing tip for deep coagulation, and a flat bare fiber for the coagulation of thin and long lesions by longitudinally moving the fiber while lasing in concert. Urology and Gynecology Fibers: The fibers are 600 microns diameter with 20 - 40 mm frosted distal tips protected by a smooth transparent cover. When used with a Neodymium:YAG (Nd:YAG) laser, the active fiber surface diffuses optical radiation in a radial pattern, delivering up to 40 W power, and thus providing consistent and uniform interstitial photothermal therapy. Coagulation depth ranges from 4 to 15 mm. Animal studies in the United States and clinical studies in Europe have demonstrated the feasibility of using these fibers to treat benign prostatic hyperplasia and endometrial coagulation. Rhinology Fiber: The fiber is an 800 micron diameter flat fiber operated at 8 W power level while being interstitially pushed and pulled along its axis. A long and thin coagulated zone is produced. The fiber is routinely used for the shrinking of hypertrophic turbinates without surrounding and bone mucusal damage in ambulatory environments.
The `SwiftLase' CO2 laser flash-scanner technology for char-free ablation of tissue combined with a dedicated oral pharyngeal handpiece and a 30 W power CO2 laser provide an ideal tool for the performance of staged laser assisted uvula palatoplasty (LAUP) and tonsil cryptolysis in the office. LAUP is virtually painless and enables the treatment of non apneic snoring problems in three to five 10 minute office sessions under local anesthesia. The addition of flexible CO2 laser fiber delivery systems extends the use of the office CO2 laser to nasal cavity procedures such as turbinate shrinking.
We describe here a highly durable 600 (mu) optical fiber with a 20 mm frosted distal tip protected by a smooth transparent cover that is capable of remaining in contact with tissue for prolonged periods. When used with a Neodymium:YAG (Nd:YAG) laser, the active fiber surface diffuses optical radiation in a radial pattern, delivering up to 40 W power, and thus providing consistent and uniform interstitial photothermal therapy. Animal studies in the United States and clinical studies in Europe have demonstrated the feasibility of using these fibers to treat a variety of soft-tissue pathologies, including benign prostatic hyperplasia.
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