Lumenis Vision’s Digital Duet takes gold-standard laser glaucoma treatment and posterior capsulotomy to the next level with its advanced digital and connectivity capabilities. The platform provides a comprehensive solution for digital imaging, treatment, and practice efficiency. In addition, it can automatically integrate with most EMRs.

“Before the Digital Duet’s introduction, only the operating physician could see a procedure being performed,” says Itay Mayer, managing director of Lumenis Vision. “Now, doctors can take pictures and videos before, during, and after treatment to share with patients, staff, and students, which enhances discussions about procedures. Physicians can also document treatments, easily share data, and store images.”

Nathan M. Radcliffe, MD, clinical associate professor in the department of ophthalmology at the New York Eye and Ear Infirmary in New York City, says the laser’s imaging capabilities make it a great teaching tool. He uses it to educate students, technicians, patients, and family members. “Multiple students can watch procedures live on a large screen,” he says. “It enhances the educational experience.”

In certain circumstances, Dr. Radcliffe, who provided feedback during the laser’s development and uses it in his practice, says it’s useful to replay a procedure for patients and their families. For example, “If a patient questions whether or not they needed a laser treatment, you can show them what you did in order to make them feel more comfortable with therapy,” he says.

By being integrated with an EMR, the Digital Duet is also a big time saver. Without it, administrators had to manually enter into an EMR what a laser was used for, such as how many shots were fired and how much energy was used. Now, data automatically go into each patient’s file and can easily be shared with other physicians and insurance companies.

“The platform eliminated a lot of documentation steps, including dictation, transcription, reviewing, scanning, and uploading to the EMR,” Dr. Radcliffe says. “Now I just hit ‘print’ to generate reports.” Because it’s a digital system, it can connect to the Lumenis engineering department to make any repairs or upgrades remotely and quickly.

Another benefit is the platform’s excellent image quality, Dr. Radcliffe says. It has features for changing brightness and focus, and can capture ocular pathology. The platform offers state-of-the-art optics for optimal visibility of the trabecular meshwork and anterior segment.

How It Works

As a combined YAG and SLT laser, the Digital Duet can be used for 3 main procedure types: SLT, iridotomy, and capsulotomy. An additional feature of the system is SmartV titratable on-axis/off-axis illumination. “This improves visualization during a capsulotomy and iridotomy and enhances illumination of vitreous opacities,” Mayer says.

“The SmartV can split light — it uses 2 prisms to bend the light and allows for coaxial visualization while firing the laser,” Dr. Radcliffe says. “This is particularly useful for treating a floater in the vitreous. Before hitting the fire button, you can make sure your aim and shot is perfect. The laser can break up floaters and makes them less noticeable.”

Ease of Use

As a laser designed to perform procedures, the Digital Duet provides a comfortable place for the patient to receive treatment and enables physicians to be in a comfortable position to administer it. “I think it’s as good as a laser can get,” Dr. Radcliffe says.

The laser comes with a wheelchair-accessible table, enabling these patients to be closer to the laser, which is more comfortable for them as well as the physician.

Perfect Timing

Now that new evidence indicates that selective laser trabeculoplasty should be the first-line treatment for open angle glaucoma and ocular hypertension, the timing of Digital Duet’s debut is impeccable. The LiGHT¹ study showed that using laser treatment for ocular hypertension and/or glaucoma first can help to prevent the need for glaucoma surgery, saves money for both patients and practices, and helps prevent vision loss due to worsening glaucoma, Dr. Radcliffe says.

Dr. Radcliffe gets better patient outcomes when using the laser in lieu of drops, because drops only work if patients use them. Patients can forget to use them, get confused about their administration, or fail to purchase them as needed.

As of late 2020, Dr. Radcliffe performed 30 laser treatments a week. Two years ago, he reported doing up to 5 per week. “This has changed, because every open-angle glaucoma patient is getting laser treatment, with a few exceptions,” he says.

Benefits for patients extend beyond no longer needing eye drops. Laser treatment is reimbursed by most insurance companies, it removes the chance of patients getting red eye from drops, it gives patients better control of glaucoma, and patients can save money by avoiding high copays for prescription drops.

Financial Advantages for Practices

Practices can also benefit financially by using the Digital Duet. “Most practices have a full-time employee to answer calls from pharmacies and fix prescriptions,” Dr. Radcliffe says. “If an office can rely less on writing prescriptions, it can avoid hemorrhaging money on patients who use them.”

In addition, a slit lamp camera can cost $40,000, require annual contracts, and break down, and they don’t always integrate with rest of a medical record. “The Digital Duet has enabled us to offer imaging at all of our practices and saved us from needing to purchase another imaging system,” Dr. Radcliffe says.

“Now is a good time to invest in a laser if you don’t have one or upgrade if you have an old laser.” Dr. Radcliffe concludes. “Dive into this new era of laser first to treat glaucoma.” GP

Reference

1. Gazzard G, Konstantakopoulou E, Garway-Heath D, et al. Selective laser trabeculoplasty versus eye drops for first-line treatment of ocular hypertension and glaucoma (LiGHT): a multicentre randomised controlled trial. Lancet. 2019;393(10180):1505-1516.