Abstract
Purpose: :
To analyse laser parameters and outcomes with the Pascal® photocoagulator which delivers a pattern array of multiple sequential burns while reducing the pulse duration to 10 ms for macular photocoagulation and 20 ms for PRP.
Methods: :
Retrospective case note review of 313 patients divided into - group A - patients undergoing PRP for PDR, group B - patients undergoing focal treatment for CSME, group C - patients undergoing grids for diffuse diabetic macular oedema, group D - patients undergoing sector PRP for ischaemic BRVO, group E - patients undergoing PRP for ischaemic CRVO, group F - patients undergoing treatment for macular oedema secondary to BRVO, group G - patients with rubeosis iridis and neovascular glaucoma secondary to BRVO, CRVO or PDR who underwent PRP, and group H - patients undergoing retinopexy for retinal breaks.
Results: :
Mean Logmar visual acuity for all procedures improved after laser but was not statistically significant (p=0.065). 72% of procedures were successful and 28% were unsuccessful at a mean follow-up of 5 months. No laser related complications were observed. Topical anaesthesia was sufficient in all patients. Significantly higher powers were required with Pascal® than with conventional laser (p=0.001). Single session PRP was performed in 15 group A patients using a mean of 1952 burns, 10 of which were successful, but 5 needed further laser.
Conclusions: :
This method offers significant benefits while remaining consistent with standard protocols. Outcomes are comparable with conventional laser. The shorter pulse duration necessitates the use of higher power but this is not associated with any adverse effects.
Keywords: laser • diabetic retinopathy • vascular occlusion/vascular occlusive disease