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

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

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose - We performed a study of laser panretinal photocoagulation in 20 patients with proliferative retinopathy. We compared short exposure, high-energy laser settings with conventional settings, using a 532?nm, frequency doubled, Neodymium–Yag laser and assessed the patients in terms of pain experienced and effectiveness of treatment.
Methods - Twenty patients having panretinal photocoagulation for the first time underwent random allocation to treatment of the superior and inferior hemi-retina. Treatment A used ‘conventional’ parameters: exposure time 0.1?s, power sufficient to produce a visible grey-white burns, spot size 300?µm. The other hemi- retina was treated with treatment B using exposure 0.02?s, 300?µm and sufficient power to have similar endpoint. All patients were asked to evaluate severity of pain on a visual analogue scale. (0=no pain, 10=most severe pain). All patients were masked as to the type of treatment and the order of carrying out the treatment on each patient was randomised. Patients underwent fundus photography and were followed up for 6–45 months.
Results - Seventeen patients had proliferative diabetic retinopathy, two had ischaemic central retinal vein occlusion and one had ocular ischaemic syndrome. The mean response to treatment A was 5.11, compared to 1.40 treatment B, on the visual analogue scale, which was statistically significant (P=0.001). All patients preferred treatment B. Further treatments, if required, were performed with treatment B parameters and long-term follow-up has shown no evidence of undertreatment.
Conclusions - Shortening exposure time of retinal laser is significantly less painful but equally effective as conventional parameters.
Original languageEnglish
Pages (from-to)96-99
Number of pages4
JournalEye
Volume22
Issue number1
Early online date23 Nov 2007
DOIs
Publication statusPublished - Jan 2008

Keywords

  • adult
  • aged
  • follow-up studies
  • humans
  • laser coagulation
  • middle aged
  • pain measurement
  • pain threshold
  • postoperative pain
  • reproducibility of results
  • retina
  • time factors
  • laser photocoagulation
  • pain

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