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Clin Ophthalmol. 2012;6:289-96. doi: 10.2147/OPTH.S27859. Epub 2012 Feb 27.

Pain and accuracy of focal laser treatment for diabetic macular edema using a retinal navigated laser (Navilas).

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1
Department of Ophthalmology, Ludwig Maximilian University of Munich, Germany.

Abstract

AIM:

To investigate treatment-related pain and the accuracy of navigated laser photocoagulation in the treatment of clinically significant macular edema.

METHODS:

Focal laser treatment of diabetic macular edema in 54 consecutive patients was digitally planned on fundus images and performed using the navigated laser photocoagulation system Navilas(®) (OD-OS GmbH, Teltow, Germany). Treatment-related pain was quantified on a visual analog scale directly after treatment and compared with a matched control group who received conventional laser treatment (n = 46). In addition, for Navilas-treated patients, the accuracy of spot placement on color images was analyzed 1 month after treatment.

RESULTS:

In total, 5423 laser spots (mean 100 per eye) were analyzed. With navigated treatment, 90% of laser spots were visible on color images, of which 96% were within 100 μm from the target. Eighty percent of the laser spots were placed and visible within the 100 μm target on an intention-to-treat basis for color imaging. Optical coherence topography confirmed that laser effects were limited to the outer retina. Treatment-related pain following navigated laser photocoagulation was significantly lower than that of conventional laser treatment (1.6 vs 4.4 on a visual analog scale, P < 0.001).

CONCLUSION:

Navigated laser effects could be visualized to a high percentage on post-treatment color images, and their location showed a high concordance to targeted areas. Patients reported that treatment-related pain following Navilas laser photocoagulation was significantly lower than pain following conventional laser treatment.

KEYWORDS:

diabetes; diabetic retinopathy; navigated laser therapy; pattern laser

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