Competitive Analysis - West Coast Laserwestcoastlaser.com/files/pdfs/spectra/Spectra...
Transcript of Competitive Analysis - West Coast Laserwestcoastlaser.com/files/pdfs/spectra/Spectra...
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Competitive Analysis
JULY 2011
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• Versatility - SPECTRA does many things to cover wide range of indications from epidermal
pigmented lesions of freckes, seborrheic keratosis, café au lait to dermal pigmented lesions of melasma, PIH, tattoos, nevus of ota, abnom, large pore, and inflammatory acne, etc.
• Melasma - With the true 5~7ns of Very Short Pulse Duration and High Peak Power, compared to a
competitor with 5~20ns which produces only the first pulse of 5 ns and then the peak power drops off immediately that SPECTRA is the clearly best choice for improving melama.
• New Theory of SSP - The new Sub-Cellular Selective Photothermolysis theory gives serial
removal of melanin in epidermal melanocytes and dermal melanophages without destroying or activation of the melanocyte.
• Active Acne – SPECTRA’s only Quasi-Long Pulse of 300 microseconds of SPECTRA MODE provides
additional photothermal stimulation of the epidermis and dermis by gently heating and mildly exfoliating the outermost layer of the skin to greatly improve active acnes.
• Safest & Reliable Laser - More than 13 years of experience in Q-Switched Nd:YAG laser
with over 3000 installations of SPECTRA worldwide, Lutronic provides high quality, reliable and safest lasers.
"Proprietary & Confidential" - Lutronic
Gold standard for melasmaSPECTRA Highlights
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3
Seborrheic Keratosis
Freckles
Café Au Lait
Melasma PIH
Active Acne Hori’s Nevi Large Pores
Nevus of Ota Tattoo
532 nm Wavelength 1064 nm Wavelength
With SPECTRA, wide-range of indications can be treated
• Epidermal Pigmented Lesions: Freckes, seborrheic keratosis, café au lait,
• Dermal Pigmented Lesions: melasma, PIH, tattoos, nevus of ota, abnom, large pore, and inflammatory acne.
Gold standard for melasmaVersatility: Wide-Range of Indications
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0 5 10 15 20 0 5
4
SPECTRA’s only 5 to 7 nsec pulse width, has high enough peak power to breakdown its chromophore (melanin).
Less lateral thermaldamage which minimizesinflammation, thuspreventing side effectsuch as PIH or melasma recurrence.
Other products could not reach the same peak power due to its longer pulse width.
High Peak Power
Competitor A Peak Power
SPECTRA Peak Power
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Gold standard for melasmaPeak Power Comparison
Peak Energy: 100 megawatts
Pulse duration
5nsec 10nsec 20nsec 5nsec 10nsec 20nsec
Peak Energy: 100 megawatts
Pulse duration
Po
wer
Po
wer
• Peak power dramatically drops off after the first pulse on lower energy's. User can hear it drop from 5ns to 20 ns after the first shot. This is not effective for treating melasma
• Peak power is very stable throughout the treatment which maintains 5ns to 7ns for effective melasma treatment.
Competitor A Peak Power SPECTRA Peak Power
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Competitor A [PTP off] Spot Size : 4mm fluence : 8J/㎠
• Competitor A: Due to the irregular and excessive beam profile, there’s possibility of side effects as shown above
00 Dermatology clinic, Korea
1064 Beam Profile Skin Reaction
Competitor A 1064nm Arm mode Beam SPECTRA 1064nm Arm mode Beam
Spot Size : 8 mm Fluence : 1.6 J/㎠ Spot Size : 8 mm Fluence : 1.2 J/㎠
• SPECTRA: Even distribution of energy shows that there’s no excessive or irregular distribution of energy. Thus, doctors can expect the optimal clinical outcome without side-effects
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PTP(Point to Point)SPECTRA is very stable at 532nm wavelength. The energy variable found in the other competitors are usually 30% deviation.
SPECTRA’s PTP shows less than 10% deviation.
As the 532 energy (PTP) is lower, the energy is more stable. Competitors have high PTP that energy is unstable.
The stable energy distribution of SPECTRA results expected clinical outcome.
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532 Energy Distribution Comparison
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Competitor B shows that excessive and irregular beam profile. Below is not Top Hat mode
Spot Size : 6 mm Fluence : 0.8 J/㎠ Spot Size : 6 mm Fluence : 1.3 J/㎠
Competitor A 1064nm Arm mode Beam SPECTRA 1064nm Arm mode Beam
532 Arm Mode Comparison
Competitor B 532m Arm mode Beam SPECTRA 532nm Arm mode Beam
Spot Size : 2.6 mm Fluence : 3 J/㎠Spot Size : 3 mm Fluence : 3 J/㎠
SPECTRA’s 532 Arm mode beam shows that energy is evenly distributed. Also shows the true top hat beam profile.
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TOPHAT
BeamProfile
SPECTRA
GAUSSIAN
Beam
Profile
▶ Uniform Energy Distribution▶ No hot spots—even ditribution of energy (green) ▶ Energy is absorbed uniformely to the melanin.
▶ Irregular Energy Distribution▶ High energy in the center and uneven energy distribution on the edge▶ Irregular absorption to the melanin. Burn in the center
NO hot spots!
TOP HAT BEAM PROFILE(I)
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SPECTRA’s TOP HAT vs. GAUSSIAN BEAM PROFILE
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TOP HAT BEAM PROFILE(II)
Whitening after treatment
After 1 minute, energy is evenly diffused that mild
and even erythema is seen
TOPHAT
BeamProfile
532
10
1.0J/cm21.3J/cm21.6J/cm21.9J/cm22.1J/cm2
Immediate after
1min. after
Skin Reaction at Skin Type IV, 2.6mm Spot Size
SPECTRA’s TOP HAT BEAM PROFILE skin reaction
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GAUSSIAN BEAM PROFILE
Immediate 30 secs 2 mins 5 mins
Whitening after treatment
Erythema due to strong energy on the treated area
Bleeding after 5 minutes due to irregular energy
distribution
GAUSSIAN
Beam
Profile
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GAUSSIAN BEAM PROFILE skin reaction
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Brand Name Spectra Medlite C Series (C6) RevLiteCompany Lutronic Corporation HOYA Conbio HOYA Conbio
Laser Type Dual Pulsed Nd:YAG Laser (1064nm
/ 532nm)
Dual Pulsed Nd:YAG Laser
(1064nm / 532nm)
Dual Pulsed Nd:YAG Laser
(1064nm / 532nm)
Power 1200mj 1000mj
1300mj not 1600mj as they claim. In all
settings it is at best 1300mj. In ptp mode
they double pulse 800mj and call it
1600mj with no clinics it is just double
pulsing. Spectra Mode has more power
as it is a continuously pulsing.
Beam Type Top-Hat Beam Profile Flat top Flat top
Quasi-long Pulsed Spectra ModeNone None
Mode (300us) Thermal Effect, Soft Peel, Acne Tx
PTP = Photoacoustic Technology Pulse
No, The Spectra Mode is more
effective with clinical’s to prove it.No
Yes it is only a double pulse of 800mj
each separated by 400 microseconds. No
proven clinical benefit. Shown not
effective on tattoo removal. No clinicals
Pulse Duration 5~7ns Very Short Pulse Duration, 5-20ns The first pulse is 5 ns and then the peak power drops off immediately
after the first shot. Explain this to the doctors that only the first pulse is good.
Peak Power of Sharp High Peak Power Beam, High Peak Power first shot only High Peak Power first shot only
1064nm No Thermal Damage No Thermal Damage No Thermal Damage
Beam Quality of 1.2J/cm21.0J/cm2 1.0J/cm2
532nm 2 Chamber Type
Handpiece Very Stable and
Uniformed beam qualityStable Stable
Initialization 7mm Zoom-Collimated Handpiece
& 1-7mm Zoom handpieceAll spot sizes are collimated All spot sizes are collimated
Guide Beam Within 30 seconds Within 5 minutes Within 5 minutes
Presets Laser Toning Button No Multiple but lots of bugs
GAUSSIAN BEAM PROFILETechnical Comparison
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By comparing each enery, Competitor B shows highter PTP which means Competitor B’s energy is NOT as stable as SPECTRA
GAUSSIAN BEAM PROFILEPTP Comparison with Competitor B
Competitor B SPECTRA
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Competitor B does not have advance pumping feature.Therefore due to unstable 532nm initial shot, PTP(%) is also very unstable.However, after the first few shots PTP(%) gets stabilized.
GAUSSIAN BEAM PROFILE532nm Energy Stability with Competitor B
Competitor B
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1064nm Arm mode Beam Profile - 800mJ Output Energy, 10Hz Pumping
The intensity in the center of the beam is not regular but distributed and concentrated in the middle
GAUSSIAN BEAM PROFILE1064 Arm Mode Comparison: Competitor B
Competitor B SPECTRA
The intensity in the center of the beam is regular and shows even distribution of the energy
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532nm Arm mode Beam Profile - 400mJ Output Energy, 4Hz Pumping
GAUSSIAN BEAM PROFILE532 Arm Mode Comparison: Competitor B
Competitor B SPECTRA
The intensity in the center of the beam shows close to regular energy distribution but it is not a Top Hat mode. It is rather showing Gaussian mode
The intensity in the center of the beam shows even energy distribution and shows true Top Hat mode.
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Laser toningfor melasma
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Gold Standard Technique
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Courtesy of I.H.Kim MD., Korea
Treated
Untreated
Before After
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Subcellular Selective Photothermolysis
SSP: Subcelluar
Selective
Photothermolysis in
melanosmes without destroying
or activating the melanocytes
(epidermal melanosome and
dermal melanophages)
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Changes of pigmentations
in the black stripe of zebra-fish 5 days after LT
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Figure. Ultrastructural changes of melanosomes in melasma patient.
A,B,C: before treatment, fully-developed stage IV melanosomes; D,E,F: after treatment,internal electron lucency and disruption of internal contents after treatment. (A-F;x100,000)
A B C
D E F
Ultrastructural changes of melanosomes
Before
After
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• In Asians referred to as ‘laser toning (LT)’ therapy in melasma was introduced to overcome the PIH by excessive thermal damage which usually occurs after conventional high fluence Q-switched laser therapy.
• Laser Toning: Use 1064nm Q-switched Nd:Yag laser, with short pulse(5nsec), low fluence(1.4~2.0J), large spot(7mm) with top-hat collimated beam mode, even though SP reaction is minimal.
Ho SG , Chan HH. The asian dermatologic patient: review of common pigmentary disorders and cutaneous diseases. Am J Clin Dermatol 2009;10:153-68.
Why we need Laser Toning
and What is it?
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Mechanism of melanin destruction
“Minimal Thermal Damage” +
“Subcellular Selective Photothermolysis”
1064nm Q-switched pulse
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Laser toning tx. Steps – 3 OR 1
1st pass
2nd pass
1. Continue or Select Q-switched Mode (5 – 10nsec Short Pulse)
2. 2 – 5 passes (End point is mild erythema)Treat
Melasma area only !!
Melanin
Breakdown
24
Fluence 1.0J/cm2 ~
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Immediate post tx. skin reaction
Before Immediately After
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New Modality in Laser Therapy :
“Laser Toning” (LT) Technique
1. Serial removal of overproduced
melanin without destroy or
activation of epidermal melanocytes
2. Serial removal of persistent
melanin in dermal melanophages
without destroy or activation of
melanocytes
4 Removal ?
PG E2 & D2, TX B2, LT C4 & D4 - Anti-inflammation
1
2
3
PersistentMelanophage?
Tyrosinase inhibitors
Subcellular Selective Photothermolysis(SSP) without cell death
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STUDY 1.
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Study 1.
Befor
e
Excellent Improvements
Before After 7th session
Before After 7th session
Before After 8th session
Before After 8th session28
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Study 1.Moderate Improvements
Before After 7th session
Before After 7th session
Before After 8th session
Before After 8th session29
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Split-Face Comparison Crossover Prospective Study
STUDY 2.
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The lesion of melasma was mostly cleared after 8 weeks laser Tx. However, the improved lesion was aggravated after 8 weeks TC treatment.
(A) Before Tx, (B) after 8 weeks laser Tx, (C) after 8 weeks TC Tx.
2nd Study
Clinical Efficacy-Cases
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MASI Score Comparison L* value Comparison
2nd Study: Clinical Efficacy & Safety of LT
Low Fluence Q-Switched Nd:YAG laser for Melasma with
Pre- or Post-Treatment Triple Combination Cream
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Photos courtesy of Dr. Kevin Duplechain
Before After- 8 treatments, Post 2 months
MelasmaTreatment 1: Soft Peel 1.5 J/cm2, 1 pass; Laser Toning 1.5 J/cm2, 1 pass
Treatment 2: Laser Toning 1.6 J/cm2, 2-4 passes
Treatment 3: Soft Peel 1.6 J/cm2, 1 pass; Laser Toning 1.6 J/cm2, 1 pass
Treatment 4: Laser Toning 1.6 J/cm2, 3-4 passes
Treatment 5: Soft Peel 1.7 J/cm2, 1 pass; Laser Toning 1.7 J/cm2, 1 pass
Treatment 6: Laser Toning 1.7 J/cm2, 3-4 passes
Treatment 7: Soft Peel 1.7 J/cm2, 1 pass; Laser Toning 1.7 J/cm2, 1 pass
Treatment 8: Laser Toning 1.8 J/cm2, 2-5 passes
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•
Photos courtesy of Dr. Kevin Duplechain
Before After- 10 treatments, Post 2 months
MelasmaTreatment 1: Soft Peel 1.6 J/cm2, 1 pass; Laser Toning 1.6 J/cm2, 1 pass
Treatment 2: Laser Toning 1.5 J/cm2, 3 passes
Treatment 3: Soft Peel 1.6 J/cm2, 1 pass; Laser Toning 1.5J/cm2, 1 pass
Treatment 4: Laser Toning 1.5 J/cm2, 3 passes
Treatment 5: Soft Peel 1.6 J/cm2, 1 pass; Laser Toning 1.6 J/cm2, 1 pass
Treatment 6: Laser Toning 1.7 J/cm2, 3-4 passes
Treatment 7: Soft Peel 1.7 J/cm2, 1 pass; Laser Toning 1.7 J/cm2, 1 pass
Treatment 8: Laser Toning 1.7 J/cm2, 2-5 passes
Treatment 9: Soft Peel 1.8 J/cm2, 1 pass
Treatment 10: Laser Toning 1.8 J/cm2, 3-5 passes
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Melasma
Photos courtesy of Dr. Kevin Duplechain
Before
Treatment 1: Soft Peel 1.6 J/cm2, 1 pass; Laser Toning 1.6 J/cm2, 1 pass
Treatment 2: Laser Toning 1.5 J/cm2, 3 passes
Treatment 3: Soft Peel 1.6 J/cm2, 1 pass; Laser Toning 1.5J/cm2, 1 pass
Treatment 4: Laser Toning 1.5 J/cm2, 3 passes
Treatment 5: Soft Peel 1.6 J/cm2, 1 pass; Laser Toning 1.6 J/cm2, 1 pass
Treatment 6: Laser Toning 1.7 J/cm2, 3-4 passes
Treatment 7: Soft Peel 1.7 J/cm2, 1 pass; Laser Toning 1.7 J/cm2, 1 pass
Treatment 8: Laser Toning 1.7 J/cm2, 2-5 passes
Treatment 9: Soft Peel 1.8 J/cm2, 1 pass
Treatment 10: Laser Toning 1.8 J/cm2, 3-5 passes
After- 10 treatments, Post 2 months
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Before
Melasma
Photos courtesy of Dr. Kevin Duplechain
After- 10 treatments, Post 2 months
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Efficacy and safety of 1,064-nm Q-switched Nd:YAG laser with low fluence for keloids and hypertrophic scars
Sung Bin Cho, MD et al Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
Accepted code : ms no. JEADV-2009-1007.R2
Journal of European Academy of Dermatology and
Venereology
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2008 IMCAS Singapore Oral Presentation
38
Minimized Selective
Photothermolysis: new
modality for melasma
treatment
Il Hwan Kim, MD, Korea
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2009 ASLMS Oral presentation
39
SUBCELLULAR SELECTIVE
PHOTOTHERMOLYSIS: AN ELECTRON
MICROSCOPIC EVIDENCE IN MELASMA
PATIENTS TREATED WITH
COLLIMATED LOW FLUENCE Q-
SWITCHED Nd:YAG
Jae Bin Shin, Se Yeong Jeong, Ki Woong
Ro, Soo Hong Seo, Sang Wook Son, Il-
Hwan Kim, Seoul, Korea
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2009 ASLMS e-poster
40
NEW TREATMENT FOR MELASMA
WITH THE COLLIMATED LOW
FLUENCE Q-SWITCHED Nd:YAG LASER
Se Yeong Jeong, Jae Bin Shin, Un Chul
Yeo, Won Serk Kim, Il-Hwan Kim, Jae
Hwan Kim, Korea University, Ansan, Korea
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2009 3rd ASPCR Meeting
Oral Presentation
& Poster
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7/29/2011 "Proprietary & Confidential" - Lutronic 42
Technical highlights of SPECTRA
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AUTO-CALIBRATION AND self-RESTORATION
Note: Above design is subject to minor change for further improvement.
After auto-calibration, SpectraTcan restore its energy within normal range by itself. Therefore there is no need for regular check-up by an engineer.
Also clinical outcome is always guaranteed.
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Customized Memory storage
Users can customize different indication names.
Users can customize different parameters at their preference.
Note: Above design is subject to minor change for further improvement.
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All types of handpieces (even 585 and 650 Dye handpieces) are auto-detected now.
AUTO-DETECTED HANDPIECE SPOT SIZE
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3-8 ZOOM COLLIMATED HANDPIECE, and other optional handpieces
3-8mm Zoom Collimated Handpiece(Standard)
1-7mm Zoom Handpiece(Optional)
Dye Handpiece(585nm)
(Optional)
Dye Handpiece(650nm)
(Optional)
7mm fixed Collimated Handpiece(Optional)
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Collimated Handpiece:
SoftPeel, SpectraPeel, Laser Toning
There is no spot size change regardless of the distance from the tip of handpiece and skin surface, thus more convenient to do SoftPeel, SpectraPeel, Laser Toning.
CollimatedHandpiece
No spot size change
(Collimated)
Fixed at 7mm Spot size
Sub-Qutaneous
Dermis
Epidermis
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ZoomHandpiece
ZoomHandpiece
][Cm sizeSpot
[J]Energy Fluence
2
Laser beam delivered by Zoom Hanpiece gets focused as it gets away from the tip of handpice, resulting in higher fluence on smaller spot size, so tip of handpiece should always be in contact to skin surface.
Sub-Qutaneous
DermisEpidermis
Area size affected by laser beam= Spot size
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Zoom Collimated HandPiece :
SoftPeel, SpectraPeel, Laser Toning, Pigmentary Lesions
• Spot size can be adjusted like zoom handpiece (e.g. 3-8 mm at 1064nm)
• Laser beam is still collimated (not focused). So operator can work even without having tip of handpiece in contact to skin surface.
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ZoomCollimatedHandpiece
ZoomCollimatedHandpiece
Spot size can be adjusted
Laser Beam is still collimated
Sub-Qutaneous
DermisEpidermis