Physicians: Have service and maintenance taken a back seat in priorities, since reimbursements have dropped? Prevent serious and costly failures with some essential fix-ups. Here are some pearls of wisdom to can extend your lasers' life and power.

Ion tubes, (Argons and Kryptons)...run them!! If you only have them lasing for treatment time, you're not lasing long enough. These tubes need to be lasing for periods of 1-2 hours per week. Furthermore, the more they are lasing, the better. For instance, if you schedule your Argon treatments every Thursday morning, leaving it running all morning will do wonders for maintaining the health of your laser tube. If, however, you only turn it on and off as patients present themselves, the laser isn't being run enough.

Why? If they don't lase, the near vacuum pressure inside the tube (normally 50 to 150 millitorre) will start to go over pressure because the sealed laser tubes are actually permeable to the higher outside atmospheric pressure. When in disuse, the atmospheric pressure (1000 millitorre) will invade the tube, bringing in contaminants such as water vapor, and raise the internal tube pressure to the point where it significantly drops your available power for the amount of electrical current that the tube is designed to run at. There is a critical point, (depending on tube, manufacturer, etc.) usually around 500 millitorre, where your available power starts to drop dramatically. You can do your own maintenance by checking your max power monthly.
If your display or meter shows that it is 30 percent or lower than the maximum you should have available, start running the laser much more than usual. Much more. Run it (lasing) for at least 2 hours more per week. After two months, it is likely you will see more power available on your meter or display.

{This is not true for HGM lasers as they show you displayed power, based on the current across the tube, and not a sample of the actual power of laser beam being emitted, like most ophthalmic lasers.) There are other exceptions. It is basically true for ophthalmic lasers which have an aiming beam that is blue/green or green. If your laser has a red aiming beam, you likely have an "on-demand" laser, which only lases for a period, during the exposure time. That, even cumulatively, is a very short period of time the tube is lasing.

These "on-demand" systems have another pitfall. They are generally water cooled. You may not have hoses connected to it, but they may be self-contained water-cooled and be very low in coolant. Every six months, the coolant must be physically checked and topped off. The same is true of solid state lasers. These photocoagulaters, (often mis-named as "diode" lasers) are often internally water cooled as well. Although they don't have pressure problems like Ion tubes, a simple lack of reservoir coolant can send them to the scrap heap.

Checking your max power regularly is as important as checking your BP or IOP regularly. High pressure is as bad for the tube as it is for the Orb.

If max power displayed is down, or you need more displayed power to do the same treatment that you did at lower power settings last year, you need to consult your manufacturer, or a qualified ophthalmic laser technician that you trust. Trust those that will suggest actions that you can do yourself, and run tests that they suggest to diagnose your problem. (Suspect those that only want to schedule a service call immediately.)

For more information about prolonging the life of your laser, contact Jeff Robinson of Laser Care.

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