Utility of Large Spot Binocular Indirect Laser Delivery for Peripheral Photocoagulation Therapy in Children

Abstract

T he purpose of this article is to demonstrate the utility of the large spot size (LSS) setting using a binocular laser indirect delivery system for peripheral ablation in children. One patient with bilateral retinopathy of prematurity received photocoagulation with standard spot size burns placed adjacently to LSS burns. Using a pixel analysis program called Image J on the Retcam picture, the areas of each retinal spot size were determined in units of pixels, giving a standard spot range of 805 to 1294 pixels and LSS range of 1699 to 2311 pixels. Additionally, fluence was calculated using theoretical retinal areas produced by each spot size: the standard spot setting was 462 mJ/mm 2 and the LSS setting was 104 mJ/mm 2 . For eyes with retinopathy of prematurity, our study shows that LSS laser indirect delivery halves the number of spots required for treatment and reduces fluence by almost one-quarter, producing more uniform spots.

Intermediate Uveitis

“…Vitreous hemorrhage, retinal neovascularization, retinoschisis, and concomitant vitrectomy are additional reasons for laser photocoagulation [205,206]. Wide-spot laser may provide more evenly distributed treatment [207].…”