Patient Comfort Using Green vs. Yellow Pan Retinal Photocoagulation
Fjalë kyçe
Abstrakt
Përshkrim
As demonstrated in the Diabetic Retinopathy Study (DRS), panretinal photocoagulation (PRP) reduces the risk of severe vision loss in patients with proliferative diabetic retinopathy. The DRS recommended that PRP treatment consist of 1,200 - 1,600 laser burns 500 µm in size, one half to one burn width apart, applied to the peripheral retina in a scatter fashion. Most patients who undergo PRP experience discomfort/pain during the procedure. Once present, pain can affect the number and quality of burns delivered and can indirectly increase the number of sessions required to complete the therapy.This may in turn adversely affect patient compliance. Although retrobulbar and peribulbar blocks can provide adequate anesthesia for PRP, these anesthetic methods carry rare but serious risks such as retrobulbar hemorrhage. Previous studies have explored other ways to reduce discomfort related to PRP, including optimization of laser settings, oral and topical analgesics, subconjunctival anesthesia, and even acupuncture.
Currently, green lasers (521 - 532 nm wavelength) are most commonly utilized for performing PRP in clinical practice. Yellow lasers (577 nm wavelength) have been of recent interest in treating diabetic macular edema with micropulse subthreshold grid photocoagulation, but have not been extensively studied in PRP for diabetic retinopathy. Compared to shorter wavelength laser, yellow laser comports high transmission through dense ocular media and less light scattering than shorter wavelengths which minimizes spot size and reduces thermal spread. The limited literature comparing green and yellow laser for PRP in diabetic retinopathy has shown that yellow laser requires less power to achieve a retinal burn. In theory this should translate into a reduction in perceived pain experienced during PRP, however a comparison of green and yellow lasers in this regard has not yet been directly examined and quantified.
Datat
| Verifikuar së fundmi: | 11/30/2016 |
| Paraqitur së pari: | 12/04/2016 |
| Regjistrimi i vlerësuar u dorëzua: | 12/12/2016 |
| Postuar së pari: | 12/15/2016 |
| Përditësimi i fundit i paraqitur: | 12/12/2016 |
| Përditësimi i fundit i postuar: | 12/15/2016 |
| Data e fillimit të studimit aktual: | 02/29/2016 |
| Data e vlerësuar e përfundimit primar: | 09/30/2016 |
| Data e vlerësimit të përfundimit të studimit: | 09/30/2016 |
Gjendja ose sëmundja
Ndërhyrja / trajtimi
Procedure: laser indirect ophthalmoscopy pan retinal photocoagulation
Faza
Grupet e krahëve
| Krah | Ndërhyrja / trajtimi |
|---|---|
| Experimental: green (532 nm) laser scatter laser indirect ophthalmoscopy pan retinal photocoagulation | |
| Experimental: yellow (577 nm) laser scatter laser indirect ophthalmoscopy pan retinal photocoagulation |
Kriteret e pranimit
| Moshat e pranueshme për studim | 18 Years Për të 18 Years |
| Gjinitë e pranueshme për studim | All |
| Pranon Vullnetarë të Shëndetshëm | po |
| Kriteret | Inclusion Criteria: - patient of Wills Eye Hospital Retina Service and/or Mid Atlantic Retina - volunteer patients age 18 years and older. - healthy enough to participate in the study. - willing and able to consent to participation in the study. - diagnosis of PDR with HRC based on clinical criteria outlined by the DRS. Exclusion Criteria: - patient less than 18 years of age - institutionalized patient - prisoner - significant media opacity obscuring a view of the superior retina - history of intra-ocular surgery except cataract surgery - history of PRP laser within the last 30 days |
Rezultati
Masat Kryesore të Rezultateve
1. Perceived patient pain assessment [a single time point within 2 minutes of completing laser treatment]
Masat dytësore të rezultateve
1. Minimum power requirement to achieve moderate gray-white retinal burns [During treatment]
2. Time of treatment [During treatment]
