Comparison of Pain Response of Patients Undergoing Panretinal Photocoagulation for Proliferative Diabetic Retinopathy: 532 nm Standard Laser vs. Multispot Pattern Scan Laser

Abstract

Purpose: To compare pain response of patients undergoing panretinal photocoagulation (PRP) for proliferative diabetic retinopathy (PDR) using 532 nm standard laser versus multispot pattern scan laser and to evaluate the relationship between pain response and patient characteristics. Material and Method: Thirty-five patients had PRP with the Pascal system in a single session, while other 35 patients had PRP with conventional laser in 2 sessions. Parameters used in conventional laser were as follows: spot size 200 µm, exposure time 0.2 s, and power sufficient to produce visible grey-white burns. We used same spot size, 20-30 ms exposure time, and higher levels of laser power in order to get a similar endpoint in the Pascal system. The patients were required to evaluate the severity of pain on a visual analog scale (VAS) and verbally 5 minutes after PRP with Pascal and 5 minutes after the first session of PRP with conventional laser. The relationship between pain experienced and patient characteristics was evaluated. Results: At baseline, both groups did not differ significantly (p >0.05, for all) with respect to sex, age, duration of diabetes, most recent HbA1c, treatment regimen, or patient experience. The patients in the Pascal group had a mean pain score of 0.55±0.70 on verbal scale and 1.54±1.22 on VAS compared to 2.17±1.18 and 5.54±3.28, respectively in the conventional laser group which was, statistically, significantly different in both scales (p<0.05). Discussion: Our study confirms that new generation pattern scanning photocoagulators satisfactorily decrease the pain by shortening the exposure time while increasing the laser power. (Turk J Ophthalmol 2013; 43: 221-4)

Keywords

• Diabetic retinopathy
• laser photocoagulation
• pain