A novel technique for creation of a peripheral iridectomy is presented which in our series of cases yielded a 100 % success rate. Constriction of the pupil is achieved by intracameral carbachol instillation to achieve a taut peripheral iris. A 23G vitrector on aspiration mode is first used to engage the peripheral iris with high vacuum. On pressing the foot switch to position two (in suction only mode, the peripheral iris is engaged and on pressing the foot switch to position three (in the cut mode) full thickness iridectomy is achieved. As a full thickness iris defect is made, the iris tissue flutters and the corresponding pupillary margin peaks towards the iris base due to aqueous currents through the newly created conduit; indicating that a patent iridectomy has been achieved.
BACKGROUND AND OBJECTIVE:
To compare large spot versus standard spot laser for treatment of retinopathy of prematurity (ROP).
PATIENTS AND METHODS:
Eighty eyes of 40 infants with bilateral type 1 ROP were randomized for laser photocoagulation using laser indirect ophthalmoscope with either standard spot or large spot size laser. During the procedure, total time taken and Premature Infant Pain Profile (PIPP) scores were noted. Regression of disease and refractive error were noted on follow-up.
RESULTS:
The infants were randomized into two groups. All infants in both groups had regression of ROP. Large spot laser significantly reduced total treatment duration in zone I by 32% (
P
= .005) and zone II by 63.4% (
P
= .0006). Moderate-to-severe pain occurred in PIPP scores in both groups throughout the procedure (under topical anesthesia) and was comparable between the groups. Mean change in refractive error (myopia) from pre-laser (2.090 diopters [D] ± 1.345 D) to 3 months' post-laser (2.465 D ± 1.399 D) was not statistically significant between the groups.
CONCLUSIONS:
Large spot laser significantly reduced total duration of laser treatment in zone I/II ROP. Large spot laser is a useful alternative for treatment of ROP in terms of faster procedure, lesser total duration of pain, and similar regression profile. It does not cause additional myopia and can be performed without additional training.
[
Ophthalmic Surg Lasers Imaging Retina.
2018;49:e233–e239.]
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