Single-Spot Yellow Laser Versus Conventional Green Laser on Panretinal Photocoagulation: Patient Pain Scores and Preferences

González-Saldívar, Gerardo; Rojas-Juárez, Sergio; Espinosa-Soto, Itzel; Sánchez-Ramos, Jorge Arturo; Jaurieta-Hinojosa, Noel; Ramirez-Estudillo, Abel

doi:10.3928/23258160-20171030-05

Cited by 5 publications

(4 citation statements)

References 11 publications

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“…Thermal diffusion of laser energy to the choroid stimulates pain receptors and is related with larger pulse durations and laser wavelengths with deeper penetration to the choroid, while less painful approaches have been described with shorter pulse durations and 532- and 577-nm wavelengths [24-28]. This has been studied in clinical trials mainly using the visual analog scale [29] or a numerical pain scale adapted from the McGill Pain Questionnaire [17].…”

Section: Discussionmentioning

confidence: 99%

Comparison of 577-nm Multispot and Standard Single-Spot Photocoagulation for Diabetic Retinopathy

et al. 2018

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Objective: To compare two different laser strategies of panretinal photocoagulation for diabetic retinopathy. Methods: Single-center, randomized study including 41 eyes treated with 577-nm multispot laser with a 20-ms pulse duration (group 1) or a 532-nm single-spot laser with a 100-ms pulse duration (group 2). The outcomes included best-corrected visual acuity (BCVA) and imaging changes at baseline, 6 and 12 months, laser parameters, and results of subjective pain analysis. Results: At 12 months, the treatments did not differ significantly in BCVA, central retinal thicknesses (CRTs), improved macular edema, vitreomacular interface changes, patient-reported pain scores, or angiographic responses. Group 1 had significantly fewer treatment sessions but used more laser spots (p < 0.001). Conclusion: The multispot laser required fewer applications with more spots delivered to compensate for lower fluency, showing similar patient tolerance to single-spot laser. Both groups maintained the initial visual acuities and CRTs; about 50% of cases had vitreomacular interface changes and improved macular edema, with similar angiographic improvements after 12 months.

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Section: Discussionmentioning

confidence: 99%

Comparison of 577-nm Multispot and Standard Single-Spot Photocoagulation for Diabetic Retinopathy

et al. 2018

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“…While the 577 nm yellow wavelength maintains a negligible uptake by macular xanthophyll and has the highest absorption rate for oxyhemoglobin to melanin absorption ratio, the 810 nm lasers have a very limited scattering in media opacities but present with relatively poor absorption by the retinal pigment epithelium (RPE) and choroid which requires higher power [ 8 ]. Although the yellow wavelength laser seems to be more popular in recent times [ 9 , 10 ] with less power required [ 11 ] and potentially less pain when using the laser for threshold applications [ 12 ], it remains debated which wavelength is optimal for the microsecond pulsing laser application. For example, Chang et al found 810 and 577 nm to be equally effective, but 810 nm had a significantly wider therapeutic range/safety margin [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Safety of various parameter sets with navigated microsecond pulsing laser in central serous chorioretinopathy

Chhablani

Kalra

Alkwatli³

et al. 2021

Int J Retin Vitr

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Background Subthreshold microsecond pulsing laser is an increasingly common treatment approach for central serous chorioretinopathy. However, there is no literature available on the safety of microsecond laser using different fluence settings in this disease. While many publications can be obtained from conventional microsecond pulsing lasers, few parameter sets are published with the navigated microsecond pulsing laser. Therefore, this study aims to investigate the safety of different parameter sets in subthreshold microsecond pulsing laser treatments. Methods In this retrospective chart review, consecutive patients with central serous chorioretinopathy (> 3 months duration of symptoms) treated with navigated subthreshold microsecond pulsing laser and a follow up of at least five months after microsecond laser application were included. For each patient, the treatment parameters, plan layout, and adverse events related to laser were evaluated. Secondary outcomes included best-corrected visual acuity and anatomical improvements (central retinal thickness). Results One hundred and one eyes were included in the observation and followed for a mean of 10 months (range 5–36). Although a larger range of parameter sets and fluence settings have been used, no patient demonstrated adverse events from navigated microsecond pulsing laser. While 88% of the cases demonstrated stability, 13 cases lost five or more letters due to the persistence of the subretinal fluid. In mean, a best-corrected visual acuity improvement of 0.07logMar (± 0.2) was seen (p = 0.02). In 51% of the patients, a statistically significant improvement of the central retinal thickness was noted at the last follow-up with a mean thickness reduction of 70 µm (± 143) (p < 0.01). Conclusion In conclusion, none of the used parameter sets lead to tissue damage (when using a cautious titration) and, in summary, lead to an improvement in subretinal fluid and improvement in visual acuity. However, further prospective studies are needed to correctly identify the dependency of the treatment strategy on the outcome criteria.

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“…Por esta razão os lasers mais usados em fototerapia, até o dia presente, são os lasers verde de estado sólido emitindo em 532 nm, isto se deve ao fato de que lasers de estado sólido são no geral de menor custo, boa portabilidade e são facilmente encontrados para compra. Estudos recentes mostraram que a fototerapia laser de retina com o comprimento de onda de 532 nm é mais dolorosa quando comparada aos tratamentos com lasers amarelos [2]. A razão para isto acontecer será melhor explicada na seção sobre fototerapia.…”

Section: Justificativaunclassified

“…A melanina encontrada principalmente no EPR e coroide absorve a maioria da luz que vai do visível ao infravermelho do espectro eletromagnético, e assim é o absorvedor mais eficiente para o processo de fotocoagulação [2,11]. A xantofila tem máxima absorção na luz azul e é encontrada predominantemente na mácula, região onde a absorção da radiação laser é desnecessária, dolorosa e pode causar danos à visão.…”

Section: 133unclassified

Laser Raman intracavidade bombeado lateralmente emitindo na região do amarelo

Ferreira¹

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Lasers amarelos são de grande interesse devido ao seu potencial de aplicação na área médica.Uma das principais aplicações ocorre no tratamento de doenças retinianas, onde a radiação amarela apresenta bons resultados clínicos com o mínimo de efeitos colaterais. Apesar dos avanços no desenvolvimento de lasers com comprimento de onda amarelo, todas as alternativas existentes possuem limitações principalmente com relação à custo e à escolha do comprimento de onda. Este trabalho foi desenvolvido com o objetivo de apresentar uma alternativa às opções existentes. Para isto foi empregado um sistema de bombeio lateral por diodo de um cristal de Nd 3+ :YLiF4 (Nd:YLF) empregando o ângulo de Brewster para obtenção de um laser com comprimento de onda fundamental em 1053 nm. Para a conversão Stokes do comprimento de onda fundamental foi utilizado um cristal de KGd(WO4)2 (KGW) em configuração intracavidade, gerando as emissões Raman em 1147 nm e 1163 nm através dos deslocamentos de Stokes principais de 768 cm -1 e 901 cm -1 . Conjuntamente foi utilizado um cristal de LBO (LiB3O5), também intracavidade, que por meio do fenômeno de geração de segundo harmônico (SHG) converte o comprimento de onda Raman em laser amarelo, gerando o comprimento de onda de 573 nm com potência máxima de saída de 6,06 W e com eficiência óptica de conversão diodo-SHG de 12%. São apresentados também resultados para um laser Raman intrínseco de Yb:KGW operando em 1096 nm na conversão Stokes de 89 cm -1 . Foram obtidas eficiência de inclinação e eficiência óptica diodo-Raman de 42 % e 33,2%, respectivamente.Palavras-chave: laser, laser de estado sólido, Nd:YLF, laser Raman, bombeamento lateral, geração de segundo harmônico, laser Raman intrínseco, Yb:KGW.

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Single-Spot Yellow Laser Versus Conventional Green Laser on Panretinal Photocoagulation: Patient Pain Scores and Preferences

Abstract: The use of YL-577 as an alternative approach for PRP reduces pain perception and is preferred by patients. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:902-905.].

Cited by 5 publications

References 11 publications

Comparison of 577-nm Multispot and Standard Single-Spot Photocoagulation for Diabetic Retinopathy

Comparison of 577-nm Multispot and Standard Single-Spot Photocoagulation for Diabetic Retinopathy

Safety of various parameter sets with navigated microsecond pulsing laser in central serous chorioretinopathy

Laser Raman intracavidade bombeado lateralmente emitindo na região do amarelo

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