Alcon Research PUREPT1 PurePoint User Manual NGL Book 1 indb

Alcon Research Ltd. PurePoint NGL Book 1 indb

User Manual part 5 of 5

8065751131 5.1SECTION FIVETROUBLESHOOTINGSYSTEM MESSAGESSystem messages advise the user of a system condition that requires an action and/or a response in order to proceed with the current procedure. Advisory MessagesAdvisory messages (see Table 5-1) are informational messages that help guide the user or bring attention to the laser’s condition. • Advisory messages appear on the same blue-gray background that many labels and prompts appear on.• Advisory messages can appear when the device is in Standby or Ready mode. They do not appear when the device is in Firing mode. • Advisory messages will cause the system to switch from Ready to Standby mode.Warning MessagesWarning messages (see Table 5-2) are precautionary messages displayed on a yellow background to inform the user of a possible safety or procedural problem that may occur in any mode. The following events take place:• The laser is placed into Standby mode.• The user is presented with one of two types of display, an Acknowledgement screen or an Operating screen, each of which asks for an action before the user continues with the procedure:The Acknowledgement Screen presents the user with information that describes the problem. The user must select a response, using the Menu knob, stating that they have seen and acknowledged the message. This acknowledgement is recorded in the laser’s system log. The display returns to the regular operating display in Standby mode. Attempting to go to Ready Mode without taking requested action results in the system continuing to display the Acknowledgement Screen.The Operating display allows the user to perform operational tasks such as adjusting the laser parameters while a warning prompt appears at the top of the screen asking the user to perform an action. After the requested action is performed, the warning prompt is removed and the display returns to the regular operating display in Standby mode. If the user tries to go to Ready mode without performing the requested action, the prompt starts blinking in order to get the attention of the user. The laser will remain in Standby mode until the action is performed.
5.2 8065751131Error MessagesErrors are major faults in the system that cannot be resolved by either software, hardware, or user action. The following events take place:• The laser is placed in a safe state (laser engine is turned off and shutter is closed).• The user is told by an error message and voice confi rmation that a fault has taken place.• The front panel controls are not functional other than the emergency shut-off switch and the On/Off key. The footswitch controls are also not functional.An error message is usually an indication that the system requires service in order to correct the problem. If restarting the system does not resolve the problem, contact your local Alcon representative to schedule a service call.Figure 5-1 Error Message
8065751131 5.3Table 5-1. Advisory MessagesMessage Displayed Condition Action“Unable to recognize probe type in Port XX.Please select probe type from options below.”An unidentifi ed fi ber is connected to a laser port. The laser fi ber may not include a RFID tag or the tag’s data may be corrupted.User must select a probe type (slit lamp, LIO, or Endo) to clear the message. “Please Insert Probe. Select the Main Menu button to view or alter settings.”Unit completes boot-up and no probe has been inserted. User must connect a fi ber to a laser port or select the Main Menu button to clear the message.“Maximum Power Available: 1.5W”(any number under 2W will be displayed; in this case it is 1.5W)Power available from the laser drops below the maximum level (2 Watts). User must acknowledge the screen prompt to clear the message.“Requested Power Not Available” The operator depresses the footswitch, but the laser is unable to deliver the power value requested. User must acknowledge the screen prompt to clear the message. User should then reduce laser power.“Service Engine Soon” The laser has a signifi cant drop in its maximum power or system detects other potential maintenance need.User must acknowledge this prompt to clear the message. If the service has not been done, the message repeats with every boot-up."Footswitch side switches control power to laser."Message is displayed at boot up to inform the user that the footswitch side switches are set to adjust power only.User must acknowledge this prompt to clear the message."Footswitch side switches may be used to change from Standby to Ready and back."Message is displayed at boot up to inform the user that the footswitch side switches have been set to switch between Standby and Ready.User must acknowledge this prompt to clear the message."Footswitch side switches have been de-activated."Message is displayed at boot up to inform the user that the footswitch side switches have been de-activated.User must acknowledge this prompt to clear the message.
5.4 8065751131Table 5-2. Warning MessagesMessage Displayed Condition Action “Footswitch Confi guration 0 Power 0 Standby/Ready” The fi rst time after system initialization that a multi-function footswitch is connected and not in Disabled mode. User must acknowledge the message to clear the screen and continue. “Verify appropriate Dr. Filters are installed in all viewing devices.” Acknowledgement Screen The fi rst time after system initialization that either a slit lamp or endo laser fi ber is selected while at least one tethered doctor fi lter is connected. User must acknowledge the message to clear the screen and continue. Verify appropriate Dr. Filters are installed in all viewing devices.” Acknowledgement Screen Either a slit lamp or endo laser fi ber is selected and no tethered doctor fi lter is connected. User must acknowledge the message to clear the screen and continue. “Please Engage Dr. Filter” Operating display A tethered doctor fi lter is disengaged. User must engage the doctor fi lter to clear the message. “Please Connect Dr. Filter” Operating display A tethered doctor fi lter is disconnected while the system is in Ready or Firing mode. User must connect a tethered doctor fi lter to clear the message. “Please Release Footswitch” Operating display Operator initiates switching from Standby to Ready while the footswitch is depressed. User must cease pressing footswitch to clear the message. “Please Connect Footswitch” Operating display The footswitch is disconnected in any mode. Footswitch must be re-connected to clear the message. “Please Close Remote Interlock” Operating display The remote interlock circuit detects a door is opened or the remote interlock plug is disconnected from the back panel. Door must be closed or plug re-connected to clear the message. “Port 1 cannot be used. Please use Port 2.” Acknowledgement Screen A fault exists on one laser port, but the other port is still usable. User must acknowledge the message and only use the functioning port.LAST PAGE OF THIS SECTION 8065751131LAST PAGE OF THIS SECTION 8065751131
8065751131 6.1SECTION SIXACCESSORIES AND PARTSThis section of the manual contains the various accessories that are available for use with the PurePoint™ Laser (see Table 6-1). If additional information is required for setup and use of the ™ Laser (see Table 6-1). If additional information is required for setup and use of the ™accessory, the Notes column of Table 6-1 provides references to that information.TABLE 6-1. PUREPOINT™ LASER ACCESSORIESDescriptionCatalog NumberNotesEndo Ocular Laser Probe, Straight, 20 Gauge8065678610Endo Ocular Laser Probe, Curved, 20 Gauge8065010203Endo Ocular Laser Probe, Straight, 20 Gauge8065010219Endo Ocular Laser Probe, Straight, 23 Gauge8065750803Endo Ocular Laser Probe, Straight, 25 Gauge8065750133Endo Ocular Laser Probe, Curved, 20 Gauge, W/RFID8065750989Endo Ocular Laser Probe, Straight, 20 Gauge, W/RFID8065750990Endo Ocular Laser Probe, Straight, 25 Gauge, W/RFID8065750978Endo Ocular Laser Probe, Straight, 23 Gauge, W/RFID8065750991Chang Aspirating Laser Probe, Curved, 20 Gauge8065010703Chang Aspirating Laser Probe, Straight, 20 Gauge8065010719Chang Aspirating Laser Probe, Soft Tip, 20 Gauge8065010739Chang Aspirating Laser Probe, Curved, 20 Gauge, W/RFID8065750979Chang Aspirating Laser Probe, Straight, 20 Gauge, W/RFID8065750980Chang Aspirating Laser Probe, Soft Tip, 20 Gauge, W/RFID8065750981Illuminated Endo Ocular Laser Probe, Curved, 20 Gauge8065010403Illuminated Endo Ocular Laser Probe, Curved, 20 Gauge8065010404Illuminated Endo Ocular Laser Probe, Straight, 20 Gauge8065010419Illuminated Endo Ocular Laser Probe, Straight, 20 Gauge8065010420Illuminated Endo Ocular Laser Probe, Curved, 20 Gauge, W/RFID8065750982Illuminated Endo Ocular Laser Probe, Straight, 20 Gauge, W/RFID8065750983Slit Lamp Front Actuating Doctor Protection Filter8065750260Microscope Front Actuating Doctor Protection Filter8065750448PurePoint™ Passive Dr. Filter8065751051Slit Lamp: Alcon® SL 1000 (CSO Table) Adaptation Fiber Strain Relief806574098280657410198065750256See pages 6-2 & 6-5Slit Lamp: Zeiss 30SL (Topcon Table) Adaptation Fiber Strain Relief8065-5010-018065750256See pages 6-2 & 6-5Slit Lamp: Haag-Streit 900 BM (Haag-Streit Table) Adaptation Fiber Strain Relief8065-5011-018065750256See page 6-3Laser Indirect Ophthalmoscope8065751050See page 6-10
6.2 8065751131SLIT LAMPS WITH DOCTOR PROTECTION FILTERS AND ADAPTATIONS A slit lamp assembly is typically used to deliver the PurePoint™ laser treatment beam to the ™ laser treatment beam to the ™patient's eye. An adaptation, mounted on the slit lamp, is required to interface the slit lamp to the PurePoint™ laser.PurePoint™ laser.PurePoint™ The adaptation consists of a zoom assembly with micromanipulator and a Doctor Protection Filter. The Doctor Protection Filter provides eye protection for the physician. The parfocal zoom assembly is used to set the spot size of the aiming and treatment beams, and a micromanipulator is provided for fi ne adjustment of the beam position.Figure 6-1 Alcon SL1000 Slit Lamp Spot sizeadjusting knobSpot sizeadjusting knobFigure 6-2 Zeiss 30SL
8065751131 6.3Figure 6-3 Haag-Streit 900BMSpot sizeadjusting knob
6.4 8065751131Figure 6-4Doctor Protection Filter Mounted Between Binoculars and Slit Lamp AssemblyConnect to Dr. filter porton laser console rear panel** Newer Doctor Protection Filters will have less tint than older ones.POSITIONING THE DOCTOR PROTECTION FILTER The Doctor Protection Filter is used to protect the surgeon from harmful laser radiation that could damage his eyes. The Doctor Protection Filter is inserted between the binoculars and the slit lamp or microscope.WARNINGS!It is the operator's responsibility to properly install the Doctor Protection Filter and verify operation. Using the instrument with a Doctor Protection Filter that is improperly installed could result in operator injury. Alcon shall not be held is improperly installed could result in operator injury. Alcon shall not be held is improperly installed could result in operatorliable for problems caused by improper installation of the Doctor Protection Filter. Defeat of the Doctor Protection Filter interlock switches and/or incorrect installation of the Doctor Protection Filter to the microscope could result in ocular hazards to the surgeon.Operator will have a colored** view through the Doctor Protection Filter due to blocking of the 532nm wavelength (green).Operator must be careful to avoid potential secondary refl ections; therefore, the room used to treat the patient should be approved by a qualifi ed laser safety offi cer. 1. Loosen thumbscrew on slit lamp assembly (or microscope) and remove binoculars (see Figure below). 2. Place Doctor Protection Filter into position on the slit lamp assembly and secure with thumbscrew. 3. Place binoculars into position on the Doctor Protection Filter and secure with thumbscrew. 4. Connect electrical cable connector to the Doctor Protection Filter port on the PurePoint™ rear panel.™ rear panel.™ 5. Perform the System Power Up instructions for the PurePoint™Laser in Section Three of this manual. Move the Doctor Protection Filter lever to disengage the fi lter and verify proper function; the message "Engage Dr. Filter" should appear. If the message does not appear, do not use the instrument; call Alcon Technical Services.
8065751131 6.5ALCON SL 1000 AND ZEISS 30SL ADAPTATIONZEISS 30SL ADAPTATIONZEISSIntroduction The Doctor Protection Filter, fi ber optic cable, mechanical micromanipulator with zoom, and beam splitter/accessories in combination with the Alcon SL 1000 Slit Lamp (or Zeiss30SL) are designed exclusively for use with the PurePoint™ laser system. This instrument ™ laser system. This instrument ™combination represents a complete ophthalmic unit. Please refer to the Alcon SL 1000 (or Zeiss 30SL) Operator's Manual for information not included in this manual. The micromanipulator with zoom provides interface between the PurePoint™ laser system ™ laser system ™and the patient. The laser spot is focused and traversed in the X and Y direction by means of the slit lamp joystick. The micromanipulator control lever provides additional positioning of the laser spot. The micromanipulator with integral zoom is used to adjust the laser spot size. The mandatory Doctor Protection Filter provides protection from the 532nm laser radiation for the attending physician. The safety circuit of the PurePoint™ laser is designed to insure ™ laser is designed to insure ™the safety fi lters are engaged (moved into place) prior to the treatment laser being operational. WARNINGS!Ensure that the terminal selection on the PurePoint™ front panel is SLIT LAMP. Verify ™ front panel is SLIT LAMP. Verify ™that the selection is correctly confi rmed. It is the responsibility of the operator to connect and confi rm the selected terminal.Operator will have a colored** view through the Doctor Protection Filter due to blocking of the 532nm (green) wavelength.To avoid potential secondary refl ections, the room used to treat the patient must be approved by a qualifi ed laser safety offi cer. All personnel in the treatment room must wear protective eyewear (OD 4 or above at 532nm) when the system is in Standby or Ready modes. Installation of the complete instrument system or retrofi tting an existing SL 1000 slit lamp with a micromanipulator with zoom, a beam splitter/accessories, a fi ber optic cable, and a Doctor Protection Filter should only be done by Alcon Service Personnel or persons authorized by Alcon.A qualifi ed technician must perform a visual inspection of the following components every twelve months: warning labels, power cords, fuses. In case of a defi ciency, do not use the system; contact Alcon Technical Services.Before each use, ensure the Doctor Protection Filter assembly, the micromanipulator with zoom, and the fi ber optic cable are fi rmly attached to the slit lamp. The user must also check the Doctor Protection Filter elements for scratches, breaks, or alterations. If scratched, damaged, or loosely attached, discontinue use of device immediately and contact Alcon Technical Services.When using beam splitter accessories, the binoculars must fi rst be attached to the beam splitter (the beam splitter accessories are attached to the beam splitter on the protected side of the Doctor Protection Filter assembly); the beam splitter is then attached to the permanently installed Doctor Protection Filter. Improper installation could cause injury to the operator and/or the patient.** Newer Doctor Protection Filters will have less tint than older ones.
6.6 8065751131Figure 6-6To avoid injury, the beam splitter/accessories must be placedbetween the binoculars and Doctor Protection Filter (Alcon SL 1000 shown)WARNINGS!Verify that the label marking the laser exit aperture is in place. Refer to the fi gure below for the location of labels on the Alcon SL 1000.Never treat a patient when the PurePoint™PurePoint™PurePoint Laser is connected to a service computer.™ Laser is connected to a service computer.™Defeat of the Doctor Protection Filter switches and/or incorrect installation of the Doctor Protection Filter assembly could result in ocular hazards to the surgeon. Please refer to the PurePoint™ Operating Instructions in section three for further ™ Operating Instructions in section three for further ™warnings.Figure 6-5Label Location Diagram on Adaptation - Alcon SL 1000 shown
8065751131 6.7Adaptation Controls Laser Spot Size Indicator - Indicates diameter of laser spot in the microscope focal plane. Laser Spot Size Adjustment Lever - Used to adjust the laser spot size. Micromanipulator Control Lever - Used to position the laser spot around the microscope center fi eld of view.Figure 6-7Controls on Alcon SL 1000 Slit Lamp with Doctor Protection Filter and Adaptation InstalledLaser spot size adjustment knobFiberoptic from EyeLite® To laser console
6.8 8065751131Operation Operation of the Doctor Protection Filter • Before operating the slit lamp, the Doctor Protection Filter cable must be plugged in and fi rmly attached to the rear panel of the PurePoint™ laser system.™ laser system.™ • The Doctor Protection Filter is operated by moving the lever from the unprotected position to the fi lter protected (engaged) position. The 532nm laser treatment beam is not operational until the fi lter lever is in the engaged position. • When using beam splitter accessories, the binoculars must fi rst be attached to the beam splitter (the beam splitter accessories are attached to the beam splitter on the protected side of the Doctor Protection Filter assembly); the beam splitter is then attached to the permanently installed Doctor Protection Filter (see Figure 6-9). Positioning and Focusing the Laser Beam 1. Move the joystick left and right to horizontally position the laser spot and illumination slits. 2. Rotate the joystick to vertically position the laser spot. 3. Move the joystick forward and backward to focus the laser spot. Adjusting the Laser Position and Spot Size 1. Following customary methods, position patient and place the contact lens on patient's eye. 2. Using the joystick control on instrument base, bring the selected area of treatment into position/focus. If desired, lock instrument base in position with instrument base slide set knob. 3. To position the laser spot, choose one or a combination of the following methods: 3.1 Using the joystick control, position the laser spot on the selected treatment area. 3.2 Using the micromanipulator, position the laser spot around the microscope center fi eld of view. 3.3 Tilt the contact lens. 4. Use the laser spot size adjustment lever to set the laser spot size.Laser Treatment of the Eye 1. The Doctor Protection Filter must be connected and in working order. To protect the user's eyes, the fi lter must be in the engaged position prior to fi ring the treatment laser. 2. For laser spot sizes ranging from 50 µm to 500 µm, the focus is parfocal; i.e., the focus of the laser spot lies in the focal plane of the microscope (see Figure 6-11). For laser spots greater than 500 µm, the laser spot sizes are set by defocusing the laser; i.e., the laser focus will not lie in the focal plane of the microscope).
8065751131 6.9 3. If the diopter adjustment(s) of the microscope eyepieces are not accurate, the object and the laser focal point will not be in the same plane (for values between 50 µm and 500 µm). Consequently, the laser spot size on the fundus will be larger than the values set on the zoom. 4. To position the laser spot, use the procedures outlined in the previous section. 5. Activate the treatment laser only if the target area has been clearly localized and irradiation by a treatment laser is warranted. Follow the operating instructions for the PurePoint™ laser to operate the laser control console and activate the laser treatment ™ laser to operate the laser control console and activate the laser treatment ™beam.WARNING!If the red aiming beam is not operating, do not use the system; contact Alcon Technical Services.Figure 6-8 Laser Spot FocusTable 6-2 Adaptation TroubleshootingSYMPTOMNo Aiming Beam(red)No Treatment Beam(532nm - green)Laser spot cannotbe positionedPROBABLE CAUSELaser not switched on.Aiming beam set too low.Fiber optic cable not connected.Aiming beam inoperative.Laser not switched on.Doctor Protection Filter not properly connected to Laser.Filters not engaged.Fiber optic cable not connected.Zero position lock knob in lockedposition.CORRECTIVE ACTIONTurn onLaser.Turn up intensity.Connect fi ber.Contact Technical Services.Turn on Laser .Connect fi lter cable to backpanel ofLaser.Properly engage fi lters.Connect fi ber.Release zero position lockknob.Troubleshooting The table below is provided as an aid in troubleshooting. Normal care should be used during the troubleshooting process to prevent the introduction of additional problems.
6.10 8065751131ALCON LASER INDIRECT OPHTHALMOSCOPE - ADVANCED TECHNOLOGY (LIO-AT) Introduction The Alcon Laser Indirect Ophthalmoscope - Advanced Technology (LIO-AT) is an accessory for use exclusively with the PurePoint™ Laser. The Alcon LIO-AT is composed of a Heinediagnostic headset with integral laser delivery adaptation and an illumination power supply. The treatment laser beam and the aiming beam are both provided by the PurePoint™ Laser. The LIO-AT is connected to the PurePoint™ Laser via a fi ber optic cable. The LIO-AT ™ Laser via a fi ber optic cable. The LIO-AT ™headset illuminator is powered by a standard desktop power supply. Prior to connecting the primary power supply, ensure the voltage indicated on the power supply label is the same as the main power outlet. The illumination light is adjustable from approximately 0 to 1000 lux using the illumination control knob on the power supply. A permanent Doctor Protection Filter protects the surgeon against incidental laser beam refl ections. The operator will have a colored** view through the Doctor Protection Filter due to blocking of the 532 nm wavelength (green). Figure 6-9 The Alcon Laser Indirect Ophthalmoscope-Advanced Technology
8065751131 6.11WARNINGS!The head-worn Laser Indirect Ophthalmoscope (LIO-AT) is designed solely for examination and treatment of the eye, particularly the retina.Use only the illumination power supply provided with LIO-AT. It is specially designed for medical applications. Insure that the selection on the PurePoint™ front panel is LIO. It is the responsibility of the ™ front panel is LIO. It is the responsibility of the ™operator to verify that the selection is correctly confi rmed. The operator will have a colored** (pink) view through the Doctor Protection Filter due to blocking of the 532 nm wavelength (green).The operator must be careful to avoid potential secondary refl ections; therefore the room used to treat the patient should be approved by a qualifi ed laser safety offi cer.All personnel in the treatment room must wear protective eyewear (OD 4 or above at 532 nm) when the system is in “Standby” or “Ready” modes.The laser delivery system is an integral part of the Alcon LIO-AT and is not designed to be used with an observer. Never use a teaching or observation system in conjunction with the LIO-AT. There is no eye protection provided for the observer.Never treat a patient when the PurePoint™ Laser is connected to a service computer.™ Laser is connected to a service computer.™Before each use of the headset, the operator must check the permanent Doctor Protection Filter for scratches, breaks, or alterations. If there is any doubt, please call Alcon Technical Services, and discontinue use of device.There are potential hazards when inserting, steeply bending, or improperly handling of the fi ber optic cable. Not following the recommendations of the manufacturer may lead to damage to the fi ber or delivery system and/or harm to the patient or user.Since the aiming beam passes down the same delivery system as the treatment beam, it provides a good method of checking the integrity of the delivery system. If the aiming beam spot is not present at the distal end of the delivery system, or its intensity is reduced or it looks diffused, this a possible indication of a damaged or not properly working delivery system. If there is any doubt, contact Alcon Technical Services.The use of fl ammable anesthetics or oxydizing gases such as nitrous oxide (N2O) and oxygen should be avoided. Some materials - for example cotton wool when saturated with oxygen - may be ignited by the high temperatures produced in normal use of the laser equipment. The solvents of adhesives and fl ammable solutions used for cleaning and disinfecting should be allowed to evaporate before the laser equipment is used. There is also danger of ignition of endogenous gases.A qualifi ed technician must perform a visual inspection of the following components every twelve months: warning labels, power cords, and fuses. In case of a defi ciency, do not use the system; call Alcon Technical Services.A qualifi ed technician must verify the LIO-AT performance by performing an LIO-AT calibration, power output, and energy matrix test every twelve months to ensure the LIO-AT is operating within specifi cations. See Section Four of this operator's manual for instructions. If the LIO-AT is not operating within specifi cations, do not use the system; call Alcon Technical Services.A qualifi ed technician must check and record ground continuity and both polarities for leakage current every twelve months to ensure they are within the applicable standards (for example: EN60601-1/lEC601-1). If they are above the applicable standards, or 50% above initial measurement, do not use the system; call Alcon Technical Services.
6.12 8065751131 Alcon LIO-AT Icons and Labels The labels and icons shown in Figure 6-10 are found on the Alcon LIO-AT and are defi ned as indicated. Figure 6-10 Alcon LIO-AT Labeling532 nm542-1476-001REVCE Identification LabelRefer to Operator's ManualLaser RadiationLaser ApertureUse appropriate take-back system (See Environmental Considerations in this manual)No Continuous Use of LIO-AT; 10 Minutes ON/20 Minutes OFF.Manufacture DateFragile - Handle Laser Fiber With CarecUL-UL Identification LabelTable 6-3 Alcon LIO-AT Technical Specifi cationsSPECIFICATIONWidth: 22.0 cm (8.7 inches)Length: 24.2 cm (9.5 inches)Height: 20.0 cm (7.9 inches)571 g (1.26 lbs.)See Heine power supply documentation.Operating: Temperature: 15º C≤ Tº ≤ 35º C Relative Humidity: 10% to 90% with no condensationStorage: Temperature: -40º C≤ Tº ≤ 70º C Relative Humidity: 10% to 90% with no condensation EyeLite® Laser complies with CE MDD requirements (CE 0123).® Laser complies with CE MDD requirements (CE 0123).®Not suitable for use in the presence of fl ammable anesthetic, oxygen, ornitrous oxide.System not protected against the ingress of water.Class IIb, IEC 601-1CATEGORYDimensionsHeadset WeightElectrical characteristicsEnvironmental LimitationsMiscellaneous
8065751131 6.13Alcon LIO-AT Safety Features • Labels on the instrument warn the operator about laser dangers. • An On/Off (I/O) switch with indicator light controls the illumination power supply. When the indicator light is ON, the illumination power supply is ON. • A protective housing covers the laser source completely and the beam will only exit through the LIO-AT exit window. • A permanent Doctor Protection Filter on the LIO-AT headset protects the operator from incidental refl ections of the laser beam. Prior to using the laser system, ensure that the fi lter is in good condition and that it has not been damaged, displaced, or moved. • An emergency switch located on the PurePoint™ console can be used to shut off power ™ console can be used to shut off power ™to the laser. After using the emergency switch, pull it back to its initial position to restore power and start the instrument.General System Precautions All personnel operating laser systems shall follow each of the general safety precautions listed below. • Never look into the laser beam. • Restrict laser room access to people whose presence is required and who are familiar with the laser precautions. • The laser room should be clearly identifi ed with proper warning signs. • Never direct the laser beam towards an opening. • Never place any refl ecting object in the path of the laser beam, or direct the laser beam toward objects that may refl ect light (such as surgical instruments). • Turn the PurePoint™ Laser OFF when not in use.™ Laser OFF when not in use.™ • Turn the LIO-AT illumination power supply OFF when not in use. • Only authorized personnel thoroughly familiar with the recommendations contained in this manual may operate the LIO-AT. Any use of this laser system beyond the design intentions may result in dangerous exposure to laser radiation. • Familiarity and understanding the use and application of the Indirect Ophthalmoscope is a prerequisite to using the LIO-AT. Power Supply For information on the desktop power supply (Heine For information on the desktop power supply (Heine For information on the desktop power supply ( EN 20-1) refer to the documentation provided with the power supply.Connecting the Alcon LIO-AT to the PurePoint™PurePoint™PurePoint Laser™ Laser™ 1. Connect the fi ber from the LIO-AT termination to the Laser Aperture connector on the PurePoint™ front panel.™ front panel.™ 2. Attach the power cord from the LIO-AT to the power supply (see Heine EN 20-1 documentation) and switch on illumination. CAUTIONDo not use the Heine standard desktop power supply EXTENSION cable (PN X-00.99.207) on the LIO-AT.
6.14 8065751131Using the Optics Overband The pivoting overband allows the laser optics to be pushed up out of the operator's fi eld of view (see Figure 6-11). It is locked in the end position and can only be released by pressing the Overband Adjustment Knob. To pivot the overband, press the Overband Adjustment Knob with the right hand and pivot the overband into the desired position (up for the “rest” position and down for the “working” position). When the unit is properly adjusted, the overband can be lowered into the same pre-selected working position. Once set, changing the adjustments is required only if another examiner uses the instrument.Figure 6-11 Adjusting the LIO-AT OverbandObservation Optics Adjustment 1. Loosen the Observation Optics Adjustment Knob (see Figure 6-36) so that the observation optics are free to move. The Observation Optics Adjustment Knob can be unscrewed and reversed to the other side for left-handed operators. Remove dust cover protecting delivery window. 2. Place the LIO-AT on your head and adjust the circumference and height using the Circumference and Height Adjustment Knobs so that the headband is fi rmly positioned but comfortable. 3. For convenience, use clothing clip to attach the fi ber/cable assembly to clothing. 4. Move the eyepieces as close as possible to your eyes and look at the light spot at a distance of 30 cm. A small object (such as a pencil) held in front of the eyepieces at 30 cm must be clearly focused. 5. Using the Delivery Mirror Control Knob, adjust the optics so that the light spot is centered vertically in your fi eld of view, then tighten the Observation Optics Adjustment Knob. 6. If the light spot is not centered horizontally, adjust the headband left or right accordingly. 7. Adjust the pupil distance setting by viewing the light spot alternately with the left eye then the right eye, and sliding the eyepieces so that the spot is centered within your fi eld of view.
8065751131 6.15 8. Remove the LIO-AT and look at the scale on the eyepieces to insure that the pupil distance is symmetrical. If not, center the headset and readjust the eyepieces. Correct adjustment of the optics is particularly important when examining small pupils.Once set, changing the adjustments is required only if another examiner uses the instrument. Controls for Observation and Illumination The Aperture Lever (see Figure 6-12) allows you to choose between two different-sized illumination fi elds. The choice of illumination fi eld size depends mainly on the size of the patient’s pupil (the small illumination fi eld is the recommended setting). The positions of the Aperture Lever for large and small illumination fi elds are marked with large and small black dots, respectively. The Convergence Control Knob provides synchronized adjustment of both examination and illumination beams to suit the patient's pupil size. Wide convergence and parallax selection allows for maximum stereopsis with large pupils. Narrow convergence and parallax selection allows stereoscopic examination for small pupils. NOTE: Use the small pupil setting and narrowest convergence angle at the small illumination fi eld size setting; otherwise, clipping (shadow) of the illumination fi eld will occur. The Convergence Control Knob adjustment range is limited in the LIO-AT to 50% of the original Heine range to accommodate for the laser beam delivery requirements.The Delivery Mirror Control Knob can be rotated to move both the illumination beam and the laser beam in the vertical plane.CAUTIONDo not use the LIO-AT with the illumination power supply set at maximum intensity for more than 10 continuous minutes. The LIO-AT must be allowed to cool down at least 20 minutes between uses. Use as little observation/illumination light as possible and always switch power supply OFF after use.CircumferenceAdjustment Knob(on backside of band)Observation OpticsAdjustment KnobLaser VerticalAdjustment KnobDelivery MirrorControl KnobHeight Adjustment KnobAperture LeverLaser Spot Size LeverConvergence Control KnobFigure 6-12 LIO-AT Controls and Adjustments
6.16 8065751131 Using the Alcon LIO-AT for Observation If the LIO-AT is used for illumination purposes only, the laser fi ber does not need to be connected to the PurePoint™ Laser. Note: Put dust cover on fi ber termination to protect fi ber when not connected to PurePoint™ PurePoint™ PurePointLaser.Laser.Laser 1. Turn the illumination power supply on. 2. Adjust the light intensity with the power supply illumination control knob. Using the Alcon LIO-AT for Laser Treatment Using the system in this mode enables photocoagulation with the LIO-AT.WARNING!All the personnel in the room during the operation must wear protective safety eyewear with a minimum optical density OD 4 to fi lter 532nm radiation.Before each use of the headset, the operator must examine the permanent Doctor Protection Filter for scratches, breaks, or alterations by looking through the ocular lens. If there is any doubt, discontinue use of device and please call Alcon Technical Service.NOTE: The LIO-AT is shipped with +2 diopter ocular lenses installed. These may be changed with 0 (zero) diopter lenses. 1. If desired, change the ocular lenses by unscrewing the eyecup retainer in the counterclockwise direction, change each lens, and replace the eyecup retainers. Ensure that the new lenses are clean, i.e. no fi ngerprints or debris. Refer to the LIO-AT maintenance section for cleaning instructions.Figure 6-13Eyecup Retainers and Ocular Lens on the Alcon LIO-AT 2. Turn the PurePoint™console power ON and make the appropriate selections as specifi ed in Operator's Manual. 3. Turn the LIO-AT Illumination power supply ON. 4. Select the appropriate illumination fi eld size by toggling the illumination aperture lever to the desired setting. 5. Adjust the illumination intensity using the power supply illumination control knob.
8065751131 6.17 6. Set the power below the nominal titration level by turning the Power Adjust knob on the PurePoint™ console counterclockwise. If the power parameter is not set below ™ console counterclockwise. If the power parameter is not set below ™the nominal titration level, the message “Set Power < xxxx mW” will appear on the display. 7. If necessary press the Reset key to reset the shot counter to 0. You can now adjust exposure time, aiming beam power, and treatment beam power. 8. Select exposure time by pressing the Exposure Time Adjustment arrow keys. If Continuous Wave mode is selected, “Mode: Continuous” is displayed.WARNING!Verify that all personnel are wearing protective eyewear (OD 4 or above at 532 nm) as soon as the system is in Standby/Ready mode, as well as during treatment. NOTE: It is not recommended to use exposure times longer than 2 seconds in CW (Continuous Wave) mode. Depending on the thermal load, the system may shut down prior to the footswitch being released. A message will appear on the display indicating this condition. 9. Select the aiming beam intensity by turning the Aiming Beam Intensity knob.WARNING!Do not attempt treatment if aiming beam is not present. Patient injury may occur. 10. Turn the Power Adjust knob to set the desired treatment power.11. Select the laser spot size using the Laser Spot Size Lever (see Figure 6-12). The positions of the Laser Spot Size lever for large (approximately 1mm) and small (approximately 0.5mm) laser spot sizes are marked with large and small black dots on the right side of the box, respectively. The change of laser spot size from large to small results in approximately four times increase in irradiance within the treatment area, provided that laser power was not adjusted.It is recommended to adjust laser power each time the Laser Spot Size Control setting is changed. Start with a low power, short duration pulse then increase until the desired coagulation result is achieved.WARNING!If unsure which settings are required, select a low power, short duration, and large laser spot size. Failure to properly adjust delivered energy may lead to patient injury.
6.18 8065751131 12. Press the Standby/Ready key on the front panel. The green Standby LED turns OFF, and the red Ready LED illuminates. NOTE: The footswitch must be released to proceed to Ready mode. If the footswitch is depressed during power-up or while in Standby mode, “Release footswitch” is displayed. Release footswitch and proceed. 13. Use the Laser Vertical Adjustment Knob (see Figure 6-12) on the laser delivery adaptation to aim the laser at the desired location within the illumination fi eld. 14. Press the footswitch when ready to fi re. The system will emit a 4 millisecond beep each time the laser fi res. If the footswitch is not pressed within 2 or 10 minutes starting from entry into “Ready” mode, the system emits one beep and switches to “Standby” mode.NOTE: The aiming beam is off during treatment beam exposure, except in repeat mode. 15. Repeat the fi ring procedure as often as necessary, making adjustments to power output and duration as appropriate to complete the treatment session. 16. When the treatment is completed, release the footswitch and press the Standby/Ready key. The green Standby LED illuminates and the system is placed in “Standby” mode.NOTE: You can disable both treatment and aiming lasers by pressing the Laser ON/OFF switch. When turning the switch ON again, the system will default to the last terminal selection used before shutdown with the exception that LIO will default to Endo. Parameters shall be restored to the selected terminal.Turn Off Sequence 1. Turn the Power Adjust knob to the minimum position. 2. Turn the key to the OFF (O) position and, for safety reasons, remove the key.NOTE: The emergency switch on the front panel must only be used in case of emergency. After using the emergency switch, pull it back to its initial position to restore power and start the instrument. 3. Place the power switch on the rear of the system in the OFF (O) position.NOTE: Between patients you can use the LASER ON/OFF switch to disable the treatment and aiming beams. The cooling system remains active in this mode. 4. Place the illumination power switch to the OFF (O) position.
8065751131 6.19ALCON LIO-AT MAINTENANCE This section contains information for basic care and maintenance of the instrument. If a problem occurs on the instrument, call the Alcon Technical Services department and give details of the breakdown circumstances and effects. From these elements, a technician will evaluate the problem and determine the maintenance requirements.WARNING!Maintenance on any part of the laser system must be performed with the laser off and the main power plug disconnected. Checking System Appearance The condition of the system hardware components must be checked periodically to identify any fault which might cause incorrect operation of the system. • Chassis appearance. • Operation of controls and indicators. • State of the fi bers and connecting cables. • Check permanent Doctor Protection Filter for damage; i.e., scratches and cracks. Any damaged hardware must be replaced. Contact your Alcon Technical Service representative.CAUTIONCare and cleaning operations must be performed with the instrument turned off and power disconnected. Headset Care and Maintenance • The eyepieces and the glass in front of the binocular assembly can be cleaned with a soft cloth (dipped in alcohol if necessary). • The cushions for forehead and nape can be removed for wiping with soapy water. • The rest of the instrument can be cleaned with a soft cloth dipped in alcohol. Under no circumstances should cleaning fl uids be used.StorageThe LIO-AT should be stored either on the Headset Stand or in the Storage Case when not in use to prevent inadvertent damage to the headset or cables.
6.20 8065751131Changing The Illumination Bulb 1. Ensure that power switches on the PurePoint™Laser and illuminator power supply are in the OFF (O) position. 2. Disconnect power cord from power source. 3. Pull the cord socket away from the bulb connector (see Figure 6-14). 4. Unscrew and remove the bulb connector, then pull the bulb out of the socket.WARNING!The bulb and bulb connector may be hot, and can burn your fi ngers.CAUTIONDo not touch the glass part of the new bulb directly with your fi ngers. Oil from fi ngers can dramatically reduce bulb life. 5. Clean the new bulb with a soft, clean cloth. 6. Insert the new bulb so its locating pin engages in the housing slit. 7. Rest the bulb connector on the base of the bulb and fi rmly screw it in. 8. Re-connect the cord socket.Figure 6-14Alcon LIO-AT Bulb ReplacementCalibrationAlcon Surgical recommends that the Laser Indirect Ophthalmoscope be calibrated on an annual basis as an integral part of the laser system with which it is used. Refer to Section Four for calibration information.ALCON LIO-AT SPARE PARTS AND ACCESSORIES Bulb 6V . . . . . . . . . . . . . . . . . . . . . .P/N 542-1119-001 Laser Protective Eyewear . . . . . . . . . Laser Protective Eyewear . . . . . . . . . Laser Protective EyewearP/N 8065750107 28 D Lens . . . . . . . . . . . . . . . . . . . . .P/N 8065750158 20 D Lens . . . . . . . . . . . . . . . . . . . . .P/N 8065-6879-01 +2 D Ocular Lens . . . . . . . . . . . . . . .P/N 301-361 0 D Ocular Lens . . . . . . . . . . . . . . . .P/N 301-362 Headset Stand . . . . . . . . . . . . . . . . . . Headset Stand . . . . . . . . . . . . . . . . . . Headset StandP/N 8065750891
8065751131 7.1SECTION SEVENINDEXTO BE DETERMINED...
7.2 8065751131LAST PAGE OF THIS SECTION 8065751131LAST PAGE OF THIS SECTION 8065751131THIS PAGE INTENTIONALLY BLANK

Navigation menu