Abstract
Purpose: :
To assess the change in retina laser practice pattern following induction of the pattern scan laser (PASCAL) where the single spot slit lamp delivery mode laser already existed.
Methods: :
Three retina specialists participated in a prospective study of 273 consecutive patients who received retinal laser. While the retina specialists performed the laser without any cross consultation one independent observer prospectively recorded the data. The independent observer also used the visual analogue scale to prospectively record the pain experienced by the patient during laser.
Results: :
Two hundred and seventy-three (138 pattern laser and 135 single spot laser) patients received 415 (234 pattern laser and 181 single-spot laser) laser procedures in a study period of five months (April- September 2009). The number of pan retinal photocoagulation (PRP) in the pattern laser group (162 of 234; 69.23%) was statistically significant (p<0.0001) than the single-spot laser group (23 of 181; 12.71%). The number of focal laser procedures was statistically significant in the single-spot laser group (98 of 181; 54.14%) than the pattern laser group (34 of 234; 14.53 %) (p<0.0001). Pain score was less in the pattern laser group (4.58 + 1.62) than the single-spot laser group (7.1 + 0.6) (p=0.003).There was one adverse event of inferior choroidal detachment in the pattern laser group following one sitting PRP, but it resolved spontaneously. There was no laser treatment related complications in the single-spot laser group of patients. The distribution of the laser systems between the laser surgeons showed the senior most physician (with 24 years of laser experience) was using pattern laser in 78% of his laser treatment and the other two treating physicians (4 and 3 years of experience) were using 58% and 26% of laser treatments respectively.
Conclusions: :
We observed a quick change to use of pattern scan laser system for PRP procedure, but not in the focal and barrage laser treatment procedures. This change was faster in the physician with longer experience with laser treatment.
Keywords: laser • retina • diabetic retinopathy