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G. Garcia-Aguirre, O. Alvarez-Verduzco, M. Lopez, S. Vera-Rodriguez, M. Martinez-Castellanos, O. Burgos-Vejar, J. Guerrero-Naranjo, J. Fromow-Guerra, V. Morales-Canton; Reduced Fluence Decreases Pain Caused by Panretinal Photocoagulation for Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2009;50(13):195.
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To measure pain perceived by diabetic patients receiving panretinal photocoagulation using reduced fluence parameters (RFP), compared to traditional parameters (TP).
Diabetic patients scheduled for panretinal photocoagulation who accepted to participate in the study were included. All eyes received at least 500 burns, using a 532 nm laser. The right eye was treated with RFP (time 20-50 msec, power 400-700 mW), while the left eye was treated with TP (time 100-200 msec, power 200-400 mW). Parameters were adjusted in both cases to obtain a gray-whitish burn. The eye to be treated first was assigned in an alternate fashion. After each eye received treatment, patients were questioned about the perceived pain using the NRS-11 scale (0 = no pain; 10 = most painful experience).
Twenty-five patients were included. Fluence per burn using RFP was 16.7 ± 10.5 J/cm2, and using TP was 35 ± 15.1 J/cm2 (p=0.000001). Pain score was 5 ± 2.19 for RFP and 7.7 ± 1.5 for TP (p=0.000058). There was a positive correlation (R2=0.4) between fluence per burn and pain perceived. No complications were observed secondary to treatment.
Using RFP seems to reduce pain secondary to photocoagulation compared to TP.
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