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AbstractDO.01.13 Retinal laser coagulation with the PASCAL® Pattern Scanning Laser First clinical experience Rüfer F., Flöhr C., Pörksen E., Roider J.
Augenklinik, Universitätsklinikum Schleswig-Holstein, Campus Kiel Objective: The PASCAL® Pattern Scanning Laser was developed to apply patterns of multiple lesions in retinal laser coagulation. As several lesions appear simultaneously, time saving can be expected, compared to single lesion technique. In the current examination first clinical experience with the system is evaluated.
Methods: The PASCAL® Pattern Scanning Laser (Optimedica Corp., Santa Clara, CA, USA) is a frequency doubled Nd:YAG Laser (532 nm), which allows the application of 1 to 56 single lesions in a rapid sequence following preselected patterns. Exposition times are 10-30 ms and power is up to 2000 mW per single lesion. In this evaluation clinical experience was gained in 33 patients. In 27 patients who underwent conventional laser coagulation in previous history (Nd:YAG-Laser, 532 nm, Carl Zeiss Meditec Corp., Jena, Germany) the subjective pain perception was evaluated. The pain of 14 patients in group 1 (pattern) and the pain of 13 patients in group 2 (single lesion) was compared to the pain of previous conventional single spot laser coagulation.
Results: 15 female and 18 male patients aged 66±10 years were included. The following diseases were treated: Diabetic retinopathy (n=21), State after central retinal vein occlusion (n=4), state after branch retinal vein occlusion (n=4), retinal hole (n=2), ocular ischemic syndrome following carotid stenosis (n=2). No complications occurred in any patient. In group 1 (pattern) 10 patients had no or less pain than in conventional laser coagulation. 4 patients had pain. In group 2 (single lesion) 6 patients had no or less pain, 7 patients had pain. Differences were not significant in Fishers exact test (p=0,17).
Conclusions: In both pattern technique and single lesion technique pain is occurring. By use of the pattern scanning technique multiple laser lesions can be applied quickly. After a short learning curve, there can be saved a lot of time. A wide understanding of the interaction between laser and tissue is necessary to avoid over coagulation.
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