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I. Zucchiatti, D. Veritti, P. Lanzetta, F. Bandello; Efficacy and Safety of Pascal Photocoagulator in the Treatment of Proliferative Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2009;50(13):194.
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To evaluate the safety and efficacy of the Pascal photocoagulator system in the treatment of proliferative diabetic retinopathy (PDR) and to report laser parameters used.
A retrospective review of twenty-six eyes of twenty-one patients with naïve severe non-proliferative diabetic retinopathy (NPDR) or PDR who underwent full PASCAL PRP between December 2006 and May 2008 was performed. Eyes included in the study received no other therapies during the follow-up period. Data were collected reviewing patient’s charts and fluorescein angiograms. Seven eyes (27%) had severe NPDR, sixteen eyes (62%) had early PDR, three eyes (11%) had high risk PDR. Panretinal photocoagulation (PRP) was performed using the PASCAL system. No efforts were done to complete PRP in a single session. The treatment was deemed successful for early and high risk PDR, at the latest follow up visit, if neovascularization had regressed and no further treatment was planned. For severe NPDR the procedure was effective if no new vessels devoloped.
The average follow up of the study group was 11.5 months (range: 6 - 19 months, C.I. 95% ±0.28). The total number of procedures was 103. On average, 3.9 sessions (C.I. 95% ±0.15) were required for a complete PRP. Parameters: mean power was 822 mW (C.I. 95% ±19.8) with an exposure time of 20 msec. The spot size used was 200-400 µm. In 21 eyes the 5x5 pattern was used (81%), whereas the 3x3 pattern was applied in 5 eyes (19%). On average 880 spots (C.I. 95% ±33.5) were delivered in each session. Nineteen eyes (73%) showed a complete regression of the new vessels; neovascularization resolved partially in seven eyes and required additional photocoagulation. No major side effects were registered in most eyes. One eye only developed a choroidal detachment after receiving 2600 spots at higher power a single session, which resolved spontaneously in one week.
The Pascal photocoagulator is safe and effective in the management of the PDR. Shortening exposure time necessitates the use of higher power to achieve the desired therapeutic endpoint. Retinal photocoagulation using PASCAL system has comparable efficacy to published results with conventional photocoagulation.
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