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Ashwin Mallipatna, Vandhana Surendranath; Focal treatment of retinoblastoma tumors with simultaneous 810nm and 532nm lasers. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3085.
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Focal laser therapy is an essential aspect of treatment of intraocular retinoblastoma, with the utilization of multiple types of lasers and methods of delivery. The effect of the 810nm laser and 532nm laser are different, and simultaneous use of both lasers on a single tumor in the same treatment session is not common. This study describes the results of using this combination of lasers on tumor response. We describe our rationale and experience in utilizing the effects of a combination of both lasers in an attempt to achieve a more rapid reduction in tumor size.
We retrospectively analyzed the simultaneous use of the 810 and 532nm lasers delivered through an indirect ophthalmoscope in 14 children with intraocular retinoblastoma.
A total of 32 tumors were individually analyzed in 18 eyes of 14 children with intraocular retinoblastoma. An initial gentle application of 810nm laser rendered the tumor opaque, without affecting the tumor vasculature. Once the tumor vasculature was clearly visible, application of the 532nm laser was able to photocoagulate this tumor vasculature. With this technique, we were able to demonstrate rapid reduction in tumor size in specific instances, along with documentation of the effect of each laser with ocular coherence tomography. None of the cases experienced laser related complications after the combination of lasers. Twenty-eight tumors went on to be inactive. Three eyes required enucleation for persistent tumor activity.
A combination of 810nm and 532nm lasers used in the same session might help augment the effect of focal laser therapy. We would suggest this technique be used in certain situations to help a rapid reduction in tumor size. Caution must be exercised to ensure that we do not over apply laser, leading to laser related complications.
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