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Comparison of navigated laser and conventional single-spot laser system for induced pain during panretinal photocoagulation

  • Onur PolatEmail author
  • Sibel Inan
  • Zeki Baysal
  • Safiye Yigit
  • Umit Ubeyt Inan
Original Article
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Abstract

To compare the panretinal photocoagulation (PRP)–induced pain response between novel navigated laser (Navilas) and conventional single-spot laser. The eyes were randomly assigned to Navilas or conventional laser. Contralateral eyes underwent PRP with the other system with 30 min resting interval. Pulse duration was 100 ms in conventional laser and 30 ms or 100 ms in Navilas and power setting was enough to create gray-white light burn on both devices. Pain response was evaluated by verbal scale (VS) (0–4) and visual analog scale (VAS) (0–10) after each PRP application. The mean age of 70 patients (140 eyes) was 62.52 ± 9.49 years. Mean power and spot numbers for Navilas and conventional laser were 291.9 ± 85.3 mW vs 368.4 ± 72.0 mW, and 375.4 ± 108.4 vs 374.2 ± 105.0 (p < 0.001 and p = 0.53, respectively). Pain scores for Navilas and conventional laser were 1.19 ± 0.73 and 1.99 ± 0.84 for VS and 2.41 ± 1.65 and 4.74 ± 2.17 for VAS (p < 0.001 and p < 0.001). More comfortable PRP is achieved with Navilas system in comparison with conventional single-spot laser system. However, small number of patients treated with same pulse duration and different contact lenses used for two systems should be taken into consideration. Besides, we did not report comparative clinical efficiency of either laser system.

Keywords

Navilas Pain Panretinal photocoagulation PRP Proliferative diabetic retinopathy 
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Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest

References

  1. 1.
    Cheung N, Mitchell P, Wong TY (2010) Diabetic retinopathy. Lancet 376:124–136CrossRefGoogle Scholar
  2. 2.
    The Diabetes Control and Complications Trial Research Group (1993) The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 329:977–986CrossRefGoogle Scholar
  3. 3.
    Reddy SV, Husain D (2018) Panretinal photocoagulation: a review of complications. Semin Ophthalmol 33:83–88CrossRefGoogle Scholar
  4. 4.
    Alasil T, Waheed NK (2014) Pan retinal photocoagulation for proliferative diabetic retinopathy. Curr Opin Ophthalmol 25:164–170CrossRefGoogle Scholar
  5. 5.
    The Diabetic Retinopathy Study Research Group (1976) Preliminary report on effects of photocoagulation therapy. Am J Ophthalmol 81:383–396CrossRefGoogle Scholar
  6. 6.
    Azoulay K, Pianka P, Loewenstein A (2012) The evolution of retinal laser technology and retinal photocoagulation as therapeutic modality. Eur Ophthalmic Rev 6:185–189CrossRefGoogle Scholar
  7. 7.
    Diabetic Retinopathy Clinical Research Network (2007) Relationship between optical coherence tomography-measured central retinal thickness and visual acuity in diabetic macular edema. Ophthalmology 114:525–536CrossRefGoogle Scholar
  8. 8.
    Kernt M, Cheuteu RE, Cserhati S, Seidensticker F, LieglRG LJ et al (2012) Pain and accuracy of focal laser treatment for diabetic macular edema using a retinal navigated laser (Navilas). Clin Ophthalmol 6:289–296CrossRefGoogle Scholar
  9. 9.
    Kozak I, Oster SF, Cortes MA, Dowell D, Hartmann K, Kim JS, Freeman WR (2011) Clinical evaluation and treatment accuracy in diabetic macular edema using navigated laser photocoagulator NAVILAS. Ophthalmology 118:1119–1124CrossRefGoogle Scholar
  10. 10.
    Lucena CR, Ramos Filho JA, Messias AM, Silva CA, Almeida FP, Scott IU et al (2013) Panretinal photocoagulation versus intravitreal injection retreatment pain in high-risk proliferative diabetic retinopathy. Arq Bras Oftalmol 76:18–20CrossRefGoogle Scholar
  11. 11.
    Wu WC, Hsu KH, Chen TL, Hwang YS, Lin KK, Li LM, Shih CP, Lai CC (2006) Interventions for relieving pain associated with panretinal photocoagulation: a prospective randomized trial. Eye (Lond) 20:712–719CrossRefGoogle Scholar
  12. 12.
    Chhablani J, Kozak I, Barteselli G, El-Emam S (2013) A novel navigated laser system brings new efficacy to the treatment of retinovascular disorders. Oman J Ophthalmol 6:18–22CrossRefGoogle Scholar
  13. 13.
    Chhablani J, Mathai A, Rani P, Gupta V, Arevalo F, Kozak I (2014) Comparison of conventional pattern and novel navigated panretinal photocoagulation in proliferative diabetic retinopathy. Invest Ophthalmol Vis Sci 55:3432–3438CrossRefGoogle Scholar
  14. 14.
    Inan UU, Polat O, Inan S, Yigit S, Baysal Z (2016) Comparison of pain scores between patients undergoing panretinal photocoagulation using navigated or pattern scan laser systems. Arq Bras Oftalmol 79:15–18CrossRefGoogle Scholar
  15. 15.
    Friberg TR, Venkatesh S (1995) Alteration of pulse configuration affects the pain response during diode laser photocoagulation. Lasers Surg Med 16:380–383CrossRefGoogle Scholar
  16. 16.
    Vaideanu D, Taylor P, McAndrew P, Hildreth A, Deady JP, Steel DH (2006) Double masked randomised controlled trial to assess the effectiveness of paracetamol in reducing pain in panretinal photocoagulation. Br J Ophthalmol 90:713–717CrossRefGoogle Scholar
  17. 17.
    Weinberger D, Ron Y, Lichter H, Rosenblat I, Axer-Siegel R, Yassur Y (2000) Analgesic effect of topical sodium diclofenac 0.1% drops during retinal laser photocoagulation. Br J Ophthalmol 84:135–137CrossRefGoogle Scholar
  18. 18.
    Cook HL, Newsom RS, Mensah E, Saeed M, James D, Ffytche TJ (2002) Entonox as an analgesic agent during panretinal photocoagulation. Br J Ophthalmol 86:1107–1108CrossRefGoogle Scholar
  19. 19.
    Inan S, Polat O, Yigit S, Inan UU (2018) PASCAL laser platform produces less pain responses compared to conventional laser system during the panretinal photocoagulation: a randomized clinical trial. Afr Health Sci 18:1010–1017CrossRefGoogle Scholar
  20. 20.
    Ito A, Hirano Y, Nozaki M, Ashikari M, Sugitani K, Ogura Y (2015) Short pulse laser induces less inflammatory cytokines in the murine retina after laser photocoagulation. Ophthalmic Res 53:65–73CrossRefGoogle Scholar
  21. 21.
    Nishida K, Sakaguchi H, Kamei M, Shiraki N, Oura Y, Wakabayashi T et al (2017) Simulation of panretinal laser photocoagulation using geometric methods for calculating the photocoagulation index. Eur J Ophthalmol 27:205–209CrossRefGoogle Scholar
  22. 22.
    Kozak I, Luttrull JK (2015) Modern retinal laser therapy. Saudi J Ophthalmol 29:137–146CrossRefGoogle Scholar
  23. 23.
    Hoeh AE, Pollithy S, Dithmar S (2015) Factors affecting laser power in retinal Navilas laser treatment. Graefes Arch Clin Exp Ophthalmol 253:849–854CrossRefGoogle Scholar
  24. 24.
    Pomerantzeff O, Schepens CL (1975) Variation of energy density in argon laser photocoagulation. Arch Ophthalmol 93:1033–1035CrossRefGoogle Scholar
  25. 25.
    Chhablani J, Sambhana S, Mathai A, Gupta V, Arevalo F, Kozak I (2015) Clinical efficacy of navigated panretinal photocoagulation in proliferative diabetic retinopathy. Am J Ophthalmol 159:884–889CrossRefGoogle Scholar
  26. 26.
    Al-Hussainy S, Dodson PM, Gibson JM (2008) Pain response and follow-up of patients undergoing panretinal laser photocoagulation with reduced exposure times. Eye (Lond) 22:96–99CrossRefGoogle Scholar
  27. 27.
    Manzella D, Paolisso G (2005) Cardiac autonomic activity and type II diabetes mellitus. Clin Sci 108:93–99CrossRefGoogle Scholar
  28. 28.
    Kozak I, Kim JS, Oster SF, Chhablani J, Freeman WR (2012) Focal navigated laser photocoagulation in retinovascular disease: clinical results in initial case series. Retina 32:930–935CrossRefGoogle Scholar
  29. 29.
    Gologorsky D, Rosen RB, Giovinazzo J, Jansen M, Landa G, Lee J (2018) Navigated retina laser therapy as a novel method for laser retinopexy of retinal tears. Ophthalmic Surg Lasers Imaging Retina 49:e206–e209CrossRefGoogle Scholar
  30. 30.
    Jung JJ, Gallego-Pinazo R, Lleo-Perez A, Huz JI, Barbazetto IA (2013) NAVILAS laser system focal laser treatment for diabetic macular edema-one year results of a case series. Open Ophthalmol J 7:48–53CrossRefGoogle Scholar

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© Springer-Verlag London Ltd., part of Springer Nature 2019

Authors and Affiliations

  1. 1.Ophthalmology ClinicAfyonkarahisar State HospitalAfyonkarahisarTurkey
  2. 2.Faculty of Medicine, Department of OphthalmologyAfyonkarahisar Health Sciences UniversityAfyonkarahisarTurkey
  3. 3.Ophthalmology ClinicBatman State HospitalBatmanTurkey
  4. 4.Ophthalmology ClinicGerede State HospitalBoluTurkey
  5. 5.Ophthalmology ClinicPark Hayat HospitalAfyonkarahisarTurkey

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