Pain response and follow-up of patients undergoing panretinal laser photocoagulation with reduced exposure times

Al-Hussainy, S.; Dodson, P. M.; Gibson, Jonathan

doi:10.1038/sj.eye.6703026

Cited by 97 publications

(74 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The application of confluent PRP is outwith the current Royal College of Ophthalmologists recommended laser treatment guidelines. 21 Despite an absence of previous published reports for long-term outcomes following Pascal 20 ms PRP in PDR, a study by Al-Hussainy and co-workers 22 in Birmingham (UK) investigated 20 ms PRP using a conventional frequency-doubled neodymium-doped yttrium aluminium garnet system. This paper mainly highlights reduced pain responses, and we have analysed the laser dosage and follow-up data described in the article.…”

Section: -19mentioning

confidence: 99%

Pascal panretinal laser ablation and regression analysis in proliferative diabetic retinopathy: Manchester Pascal Study Report 4

Muqit

Marcellino

Henson

et al. 2011

Eye

View full text Add to dashboard Cite

Aims To quantify the 20-ms Pattern Scan Laser (Pascal) panretinal laser photocoagulation (PRP) ablation dosage required for regression of proliferative diabetic retinopathy (PDR), and to explore factors related to long-term regression. Methods We retrospectively studied a cohort of patients who participated in a randomised clinical trial, the Manchester Pascal Study. In all, 36 eyes of 22 patients were investigated over a follow-up period of 18 months. Primary outcome measures included visual acuity (VA) and complete PDR regression. Secondary outcomes included laser burn dosimetry, calculation of retinal PRP ablation areas, and effect of patient-related factors on disease regression. A PDR subgroup analysis was undertaken to assess all factors related to PDR regression according to disease severity. Results There were no significant changes in logMAR VA for any group over time. In total, 10 eyes (28%) regressed after a single PRP. Following top-up PRP treatment, regression rates varied according to severity: 75% for mild PDR (n ¼ 6), 67% for moderate PDR (n ¼ 14), and 43% in severe PDR (n ¼ 3). To achieve complete disease regression, mild PDR required a mean of 2187 PRP burns and 264 mm 2 ablation area, moderate PDR required 3998 PRP burns and area 456 mm 2 , and severe PDR needed 6924 PRP laser burns (836 mm 2 ; Po0.05). Conclusions Multiple 20-ms PRP treatments applied over time does not adversely affect visual outcomes, with favourable PDR regression rates and minimal laser burn expansion over 18 months. The average laser dosimetry and retinal ablation areas to achieve complete regression increased significantly with worsening PDR.

show abstract

Section: -19mentioning

confidence: 99%

Pascal panretinal laser ablation and regression analysis in proliferative diabetic retinopathy: Manchester Pascal Study Report 4

Muqit

Marcellino

Henson

et al. 2011

Eye

View full text Add to dashboard Cite

show abstract

“…Novel laser treatment systems, however, use the multi-shot mode with short pulse duration, thereby providing shorter, less demanding, and less painful treatment sessions (16) . Furthermore, studies have shown that a short pulse duration does not negatively influence PRP treatment efficacy (16)(17)(18) . Targeting the retinal pigment epithelium while preserving adja cent photoreceptors through micro-air bubble formation formed around melanosomes is a novel target therapy modality of laser photocoagulation.…”

Section: Discussionmentioning

confidence: 99%

“…The critical threshold between thermal and mechanical damage is 50 ms (19)(20)(21) . Owing to the use of shorter pulses, novel laser therapy techniques cause only mechanical but not thermal damage, limiting the damage to the retinal pigment epithelium and preserving the inner retinal layers and sensory-rich chorioretinal tissues (17) . Consequently, patients usually report less pain, most probably because retinal sensitivity is better preserved as compared with pain in conservative approaches (9,17) .…”

Section: Discussionmentioning

confidence: 99%

“…Owing to the use of shorter pulses, novel laser therapy techniques cause only mechanical but not thermal damage, limiting the damage to the retinal pigment epithelium and preserving the inner retinal layers and sensory-rich chorioretinal tissues (17) . Consequently, patients usually report less pain, most probably because retinal sensitivity is better preserved as compared with pain in conservative approaches (9,17) . Recent studies have consistently shown that patients treated with either the PASCAL or NAVILAS laser system modalities experienced less pain as compared with those treated with conventional laser treatment modalities (9,10,17,22) .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of pain scores between patients undergoing panretinal photocoagulation using navigated or pattern scan laser systems

İnan¹,

Polat²,

İnan³

et al. 2016

Arquivos Brasileiros De Oftalmologia

View full text Add to dashboard Cite

Purpose: To compare the pain responses of patients with proliferative diabetic retinopathy (PDR) undergoing panretinal photocoagulation (PRP) using either pattern scan laser (PASCAL) or navigated laser photocoagulation (NAVILAS). Methods: Patients diagnosed with PDR were randomly assigned to undergo either PASCAL or NAVILAS photocoagulation treatment. PRP was performed using the multi-shot mode with a spot size of 200-400 µm and a pulse duration of 30 ms to obtain a white-grayish spot on the retina. Parameters were identical in both procedures. After 30 min of PRP application, patients were asked to verbally describe their pain perception as either "none, " "mild, " "moderate, " "severe, " or "very severe" using a verbal rating scale (VRS) and visual analog scale (VAS) by indicating a score from "0" to "10, " representing the severity of pain from "no pain" to "severe pain. " Results: A total of 60 eyes of 60 patients (20 females and 40 males) diagnosed with PDR were treated. The mean age of patients was 62.22 ± 9.19 years, and the mean diabetes duration was 195.47 ± 94.54 months. The mean number of laser spots delivered during PRP was 389.47 ± 71.52 in the NAVILAS group and 392.70 ± 54.33 in the PASCAL group (p=0.57). The difference in pain responses between patients in the NAVILAS and PASCAL groups was significant with regard to the mean VRS (1.10 ± 0.67 and 1.47 ± 0.69, respectively; p=0.042) and mean VAS (2.13 ± 1.17 and 2.97 ± 1.35, respectively; p=0.034) scores. Conclusions: Pain responses in patients undergoing PRP with a 30-ms pulse duration were significantly milder in the NAVILAS group than in the PASCAL group.

show abstract

“…65 More recent advances have continued to improve the experience of patients undergoing retinal laser photocoagulation by using pattern scanning laser machines, which allow ophthalmologists to perform the treatment much quicker and with less discomfort. 66 …”

Section: Diabetic Retinopathymentioning

confidence: 99%

25th RCOphth Congress, President's Session paper: 25 years of progress in medical retina

Gibson

2014

Eye

Self Cite

View full text Add to dashboard Cite

show abstract

Pain response and follow-up of patients undergoing panretinal laser photocoagulation with reduced exposure times

Abstract: Shortening exposure time of retinal laser is significantly less painful but equally effective as conventional parameters.

Cited by 97 publications

References 14 publications

Pascal panretinal laser ablation and regression analysis in proliferative diabetic retinopathy: Manchester Pascal Study Report 4

Pascal panretinal laser ablation and regression analysis in proliferative diabetic retinopathy: Manchester Pascal Study Report 4

Comparison of pain scores between patients undergoing panretinal photocoagulation using navigated or pattern scan laser systems

25th RCOphth Congress, President's Session paper: 25 years of progress in medical retina

Contact Info

Product

Resources

About