Clinical Science

Reduction of Fluence to Decrease Pain During Panretinal Photocoagulation in Diabetic Patients

Oscar Alvarez-Verduzco, MD; Gerardo Garcia-Aguirre, MD; Maria de Lourdes Lopez-Ramos, MD; Sandra Vera-Rodriguez, MD; José Luis Guerrero-Naranjo, MD and Virgilio Morales-Canton, MD

BACKGROUND AND OBJECTIVE

To assess the effect of laser fluence reduction to reduce pain during panretinal photocoagulation.

PATIENTS AND METHODS

Twenty-five patients (50 eyes) with diabetic retinopathy who had indication for panretinal photocoagulation were included in this prospective, interventional, and comparative study. The right eyes were treated using low fluence parameters (LFP), whereas the left eyes were treated with standard fluence parameters (SFP). At the end of each session, the patient was asked to rate pain from 0 (no pain) to 10 (maximum pain) for each eye (NRS-11 scale). Fluence per burn and total fluence were determined for each eye. Statistical analysis was performed using the Mann–Whitney U test and the Pearson correlation coefficient.

RESULTS

Pain perception (P < .01) and fluence per burn (P < .01) were significantly less using LFP compared with SFP. Pain was proportional to fluence per burn (R² = 0.4), but not to number of burns (R² = -0.2).

CONCLUSION

The use of LFP seems to be a good option to diminish the pain during panretinal photocoagulation.

[Ophthalmic Surg Lasers Imaging 2010;41:432-436.]

AUTHORS

From the Retina Department, Hospital Dr. Luis Sanchez Bulnes, Coyoacan, México.

Originally submitted March 24, 2009. Accepted for publication February 19, 2010. Posted online May 28, 2010.

The authors have no financial or proprietary interest in the materials presented herein.

Address correspondence to Oscar Alvarez-Verduzco, MD, Asociación para Evitar la Ceguera en México, I.A.P. Hospital Doctor Luis Sánchez Bulnes, Departamento de Retina, Vicente García Torres No. 46, colonia San Lucas, Coyoacan C.P. 04030, México, D.F.

doi: 10.3928/15428877-20100525-02