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Study of clinical applications and safety for Pascal® laser photocoagulation in retinal vascular disorders.

AbstractPURPOSE:
To establish safe laser parameter standards for 10-30 ms Pascal(®) laser in clinical practice and to evaluate clinical and visual outcomes using this 532-nm multi-spot photocoagulation system.
METHODS:
Retrospective observational case series of 313 patients treated between 2006 and 2008. Evaluation of eight groups: A - panretinal photocoagulation (PRP) for proliferative diabetic retinopathy (PDR); B - focal laser treatment for clinically significant diabetic macular oedema; C - grid laser for diffuse diabetic macular oedema; D - sector PRP for ischaemic branch retinal vein occlusions (I-BRVO); E - full PRP for ischaemic central retinal vein occlusions (I-CRVO); F - macular laser treatment for macular oedema secondary to non-ischaemic BRVO; G - full PRP for rubeosis iridis and/or neovascular glaucoma (NVG) secondary to I-BRVO, I - CRVO or PDR; H - laser retinopexy for retinal breaks/degenerations.
RESULTS:
Mean LogMAR visual acuity for all procedures improved postlaser (p = 0.065), and laser prevented visual loss in 85% eyes. Topical anaesthesia was only required. At mean follow-up of 5 months, 72% procedures had a successful clinical outcome. Significantly higher powers were required for PRP using Pascal(®) compared to conventional laser (p = 0.001) in PDR, I-BRVO, I-CRVO and NVG. Sixty-seven per cent of patients (15/20) were successfully treated with single-session 20-ms PRP using a mean 1952 burns. There were no laser-associated adverse effects or ocular complications associated with multi-spot PRP or macular Pascal(®) arrays.
CONCLUSIONS:
The clinical efficacy using 10- to 30-ms pulse duration Pascal(®) laser is comparable to conventional standard protocols used for the treatment of vascular retinal disorders. Higher power, 10- to 30-ms pulse duration laser may be safely and effectively used in clinical practice.
AuthorsMahiul M K Muqit, Chintan Sanghvi, Rita McLauchlan, Christine Delgado, Lorna B Young, Stephen J Charles, George R Marcellino, Paulo E Stanga
JournalActa ophthalmologica (Acta Ophthalmol) Vol. 90 Issue 2 Pg. 155-61 (Mar 2012) ISSN: 1755-3768 [Electronic] England
PMID20163363 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Copyright© 2010 The Authors. Acta Ophthalmologica © 2010 Acta Ophthalmologica Scandinavica Foundation.
Topics
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anesthesia, Local
  • Blindness (prevention & control)
  • Female
  • Fluorescein Angiography
  • Follow-Up Studies
  • Humans
  • Laser Coagulation (adverse effects, methods)
  • Male
  • Middle Aged
  • Retinal Diseases (physiopathology, surgery)
  • Retinal Vessels (physiopathology, surgery)
  • Retrospective Studies
  • Treatment Outcome
  • Visual Acuity (physiology)
  • Young Adult

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