Efficacy of patterned scan laser in treatment of macular edema and retinal neovascularization

Dimple Modi, Paulpoj Chiranand, Levent Akduman

Saint Louis University School of Medicine, Department of Ophthalmology, Saint Louis University Eye Institute, St. Louis, Missouri, USA

Purpose: To analyze the benefits, efficacy, and complications of the PASCAL^® photocoagulation laser system (OptiMedica, Santa Clara, CA, USA) in patients treated at our institution.

Methods: We conducted a retrospective chart review of 19 patients (28 eyes) who underwent laser treatment using the PASCAL^® photocoagulation system from November 2006 to November 2007. These 28 eyes were divided into two groups; group 1 eyes underwent macular grid laser and group 2 eyes underwent panretinal photocoagulation. Treatment was performed for macular edema or for iris or retinal neovascularization. Outcomes measured included best-corrected visual acuity (BCVA), efficacy of laser treatment, complications, duration of the procedure, and pain perception, which were noted in the charts for panretinal treatments.

Results: Follow-up was 5.9 ± 2.6 months for group 1 and 5.9 ± 4.0 months for group 2. In group 1, 9/28 eyes required a second treatment for remaining edema. BCVA was stable or better in 66% (14/21) and average central foveal thickness on ocular coherence tomography improved in 71% (15/21). Time to completion for a number of laser patterns for grid photocoagulation was felt to be too long for completing the total pattern safely, although we have not noted any related complications. In group 2, the neovascularization regressed at least partially in 3/7 patients. Patient-reported pain perception was 3.6 on a scale of 1 to 10 for group 2. Occasional hemorrhages occurred secondary to irregular laser uptake at different spots in the patterns. We observed no visual outcome consequences because of these hemorrhages during follow-up.

Conclusions: Retinal photocoagulation by the PASCAL^® laser has comparable efficacy to historical results with conventional retinal photocoagulation in short-term follow-up. PASCAL^® photocoagulation can be performed quicker with less discomfort for patients.

Keywords: diabetic retinopathy, laser, macular edema, PASCAL, patterned scan laser, photocoagulation, retinal neovascularization