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J.M. Coney, G. Gurelik, N.Z. Zakov; Binocular Indirect Panretinal Laser Photocoagulation for the Treatment of Proliferative Diabetic Retinopathy: A Retrospective Study . Invest. Ophthalmol. Vis. Sci. 2003;44(13):3982.
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Purpose: This is a noncomparative, consecutive, interventional case series that evaluates the efficacy of binocular indirect laser photocoagulation in eyes with severe preproliferative and proliferative diabetic retinopathy and in eyes undergoing pars plana vitrectomy for proliferative diabetic eye disease. Methods: A retrospective review of 209 eyes was performed to identify patients with severe preproliferative and proliferative diabetic retinopathy who had binocular indirect laser photocoagulation. Patients selected were categorized into three groups: Group 1, eyes that had no previous panretinal laser treatments (NPL); Group 2, eyes that had previous panretinal laser treatment (PL) and needed additional peripheral laser treatment; and Group 3, eyes that underwent a pars plana vitrectomy (PPVx) for a nonclearing vitreous hemorrhage secondary to proliferative diabetic retinopathy. All patients had at least 6 months of follow-up documenting visual acuity and status of diabetic retinopathy. Results: The NPL group received a mean 1465 laser spots in an average 1.32 sessions, with 80.82% of eyes having stable or improved vision. The PL group received a mean 1149 laser spots in an average 1.15 sessions, with 82.96% of eyes having stable or improved vision. The PPVx group had an improvement or stabilization of vision in 89.58% of eyes after an average 1.08 sessions with a mean 1038 laser spots. The incidence of severe vision loss was slightly increased in the NPL and PL groups, whereas there was a significant decrease in the PPVx group. A cumulative incidence rate of severe visual loss in the NPL group was 11.0%. There was evidence of neovascular glaucoma in 2.7% of the NPL eyes, 1.1% in the PL eyes, and 8.3% in the PPVx group. Although there were no retinal detachments in the NPL and PL groups, the PPVx group had a detachment rate of 2.1% of eyes. Conclusions: The results of this study indicate that, in all categories, binocular indirect laser photocoagulation decreased the incidence of blind painful eyes and should be considered as an adjunct to office panretinal laser for diabetic patients when comfort, handicaps, and progression of retinopathy is a concern.
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