Navigated Retinal Photocoagulation

B eing a retinal specialist entails mastering a multitude of techniques and everemerging technologies to ensure that patients receive the best possible care. This process begins during residency, when operating foreign equipment such as the slit lamp and indirect ophthalmoscope become second nature. In our typical workweek, we utilize dozens of technologies to diagnose, manage, and treat our patients. From contact lens examination, scleral depression, and intravitreal injection, to fluorescein angiography, the operative microscope, and wide-angle viewing systems, we cruise seamlessly from one apparatus to another without hesitation or second thought. When new technology arrives, many of us quickly adopt those that improve patient care, efficiency, or outcomes. For example, wide-field viewing in the OR required new skills and the ability to interact with a different environment, but the obvious benefits led to near universal adoption. The recent integration of optical coherence tomography (OCT) into our everyday lives shows how quickly we can integrate pieces of information that were once unfamiliar. The recent introduction of the Navilas laser (OD-OS GmbH, Teltow, Germany) represents another technological leap forward in the care of retina patients. It optimizes performance by integrating key components of the diagnostic and therapeutic process in a unique, intuitive approach that has never before been available. In this article, I discuss how the ability to register and overlay a diagnostic fluorescein angiographic or fundus image in real time to a live fundus view opens a new paradigm in retina laser photocoagulation. WHAT IS NAVIGATED PHOTOCOAGUL ATION? Navilas is a diagnostic and interventional device that integrates imaging technology with 532-nm laser photocoagulation. Although this is a unique combination in and of itself, it is only the beginning. The system can acquire mydriatic, and nonmydriatic color and infrared photos as well as fluorescein angiographic images that are equal or superior to existing systems.1 With a novel Navigated Retinal Photocoagulation