Skip to main content

Advertisement

Log in

Comparison of pain experience and time required for pre-planned navigated peripheral laser versus conventional multispot laser in the treatment of diabetic retinopathy

  • Original Article
  • Published:
Acta Diabetologica Aims and scope Submit manuscript

Abstract

Purpose

To compare the pain and the duration of a panretinal photocoagulation (PRP) session using a conventional multispot laser (Quantel Medical) versus the Navilas® laser.

Methods

Treatment-naïve patients requiring bilateral PRP for diabetic retinopathy were included. For each patient, PRP was carried out using a conventional multispot laser (Quantel Medical, 577 nm) in one eye and the other eye was treated with the Navilas laser (OD-OS, 577 nm). For both PRP treatments, similar parameters (same power, exposure time, number, size and spacing of the spots) were used. For each eye, the duration of the session and the pain, measured using respectively a chronometer and a visual analogic scale (VAS), were recorded.

Results

Thirty-two eyes of sixteen patients (mean age 57 ± 13 SD, range 28–74), 11 men and 5 women, have been included. A mean of 1289 (1000–1500) spots with a mean power of 352 mW (300–450 mW) and an exposure time of 27 ms (20–30 ms) were delivered. The PRP session with the Navilas laser (mean time of 5.2 ± 0.8 min) was faster than with the conventional multispot laser (6.6 ± 1.1 min) (p = 0.02). Laser-induced pain was significantly reduced (VAS of 2.4 ± 1.6) using the Navilas laser compared to conventional laser (VAS: 7.1 ± 2) (p < 0.001).

Conclusion

The PRP sessions using the Navilas laser were significantly faster and less painful than with a conventional multispot laser in our series.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Zheng Y, He M, Congdon N (2012) The worldwide epidemic of diabetic retinopathy. Indian J Ophthalmol 60(5):428–431

    Article  Google Scholar 

  2. Writing Committee for the Diabetic Retinopathy Clinical Research Network, Gross JG, Glassman AR et al (2015) Panretinal photocoagulation vs intravitreous ranibizumab for proliferative diabetic retinopathy: a randomized clinical trial. JAMA 314:2137–2146

    Article  Google Scholar 

  3. Beaulieu WT, Bressler NM, Melia M et al (2016) Panretinal photocoagulation versus ranibizumab for proliferative diabetic retinopathy: patient-centered outcomes from a randomized clinical trial. Am J Ophthalmol 170:206–213

    Article  CAS  Google Scholar 

  4. Gross JG, Glassman AR, Liu D et al (2018) Five-year outcomes of panretinal photocoagulation vs intravitreous ranibizumab for proliferative diabetic retinopathy: a randomized clinical trial. JAMA Ophthalmol 136(10):1138–1148

    Article  Google Scholar 

  5. Sivaprasad S, Prevost AT, Vasconcelos JC et al (2017) Clinical efficacy of intravitreal aflibercept versus panretinal photocoagulation for best corrected visual acuity in patients with proliferative diabetic retinopathy at 52 weeks (CLARITY): a multicentre, single-blinded, randomised, controlled, phase 2b, non-inferiority trial. Lancet 389(10085):2193–2203

    Article  CAS  Google Scholar 

  6. American Academy of Ophthalmology Retina/Vitreous Panel (2016) Preferred practice pattern® guidelines. Diabetic retinopathy. American Academy of Ophthalmology, San Francisco, CA

    Google Scholar 

  7. Figueira J, Fletcher E, Massin P et al (2018) Ranibizumab plus panretinal photocoagulation versus panretinal photocoagulation alone for high-risk proliferative diabetic retinopathy (PROTEUS study). Ophthalmology 125(5):691–700

    Article  Google Scholar 

  8. Early Treatment Diabetic Retinopathy Study Research Group (1985) Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study report number 1. Arch Ophthalmol 103:1796–1806

    Article  Google Scholar 

  9. Jain A, Blumenkranz MS, Paulus Y et al (2008) Effect of pulse duration on size and character of the lesion in retinal photocoagulation. Arch Ophthalmol 126(1):78–85

    Article  Google Scholar 

  10. Nagpal M, Marlecha S, Nagpal K (2010) Comparison of laser photocoagulation for diabetic retinopathy using 532-nm standard laser versus multispot pattern scan laser. RETINA 30(3):452–458

    Article  Google Scholar 

  11. Higaki M, Nozaki M, Yoshida M, Ogura Y (2018) Less expansion of short-pulse laser scars in panretinal photocoagulation for diabetic retinopathy. J Ophthal 2018:9371895

    Google Scholar 

  12. Muqit MM, Gray JC, Marcellino GR et al (2010) In vivo laser-tissue interactions and healing responses from 20- vs 100-millisecond pulse pascal photocoagulation burns. Arch Ophthalmol 128(4):448–455

    Article  Google Scholar 

  13. Muqit MM, Marcellino GR, Gray GC et al (2010) Pain responses of Pascal 20 ms multi-spot and 100 ms single-spot panretinal photocoagulation: Manchester Pascal Study, MAPASS report 2. Br J Ophthal 94(11):1493–1498

    Article  CAS  Google Scholar 

  14. Muqit MM, Marcellino GR, Henson DB et al (2011) Pascal panretinal laser ablation and regression analysis in proliferative diabetic retinopathy: Manchester Pascal Study Report 4. Eye 25(11):1447–1456

    Article  CAS  Google Scholar 

  15. Kernt M, Cheuteu R, Vounotrypidis E et al (2011) Focal and panretinal photocoagulation with a navigated laser (NAVILAS®). Acta Ophthalmol 89(8):e662–e664

    Article  Google Scholar 

  16. Kernt M, Cheuteu RE, Cserhati S et al (2012) Pain and accuracy of focal laser treatment for diabetic macular edema using a retinal navigated laser (Navilas). Clin Ophthalmol 6:289–296

    Article  Google Scholar 

  17. Kim MS, Lee SW, Kim JS (2014) Comparison of the time required for panretinal photocoagulation and associated pain between Navilas® and conventional laser therapy in diabetic retinopathy. J Kor Ophthalmol Soc 55(8):1150

    Article  Google Scholar 

  18. Chhablani J, Mathai A, Rani P et al (2014) Comparison of conventional pattern and novel navigated panretinal photocoagulation in proliferative diabetic retinopathy. Investig Opthalmol Vis Sci 55(6):3432–3438

    Article  Google Scholar 

Download references

Funding

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Francesca Amoroso.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article belongs to the topical collection Eye Complications of Diabetes managed by Giuseppe Querques.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Amoroso, F., Pedinielli, A., Astroz, P. et al. Comparison of pain experience and time required for pre-planned navigated peripheral laser versus conventional multispot laser in the treatment of diabetic retinopathy. Acta Diabetol 57, 535–541 (2020). https://doi.org/10.1007/s00592-019-01455-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00592-019-01455-x

Keywords

Navigation