Pulsed mode versus near-continuous mode delivery of diode laser photocoagulation for high-risk retinopathy of prematurity.
OBJECTIVE
To compare structural and functional outcomes and efficiency of diode laser photocoagulation for retinopathy of prematurity (ROP) when delivered in a pulsed mode versus a near-continuous mode.


METHODS
A retrospective study was conducted of 138 patients who underwent diode laser photocoagulation for threshold ROP using either pulsed or near-continuous delivery. Laser-related complications and structural and functional outcomes were analyzed. Prospectively, time efficiency and total energy used were evaluated in nine infants with bilateral symmetric high-risk prethreshold ROP in which one eye of each infant was randomized to pulsed and the fellow eye to near-continuous delivery.


RESULTS
There was no significant difference between groups with regards to prevalence of posterior disease (Zone 1 or posterior Zone 2) (p = 0.11), postoperative vitreous haze (p = 0.60), postoperative complications (p = 0.38), retinal detachment (p = 0.90), strabismus (p = 0.73), amblyopia (p = 0.69), or refractive error (p = 0.95). Mean time for treatment was 23 minutes using pulsed delivery versus 14 minutes per eye with near-continuous delivery (p < 0.001). The mean total power used per eye with pulsed mode delivery was 1.5 x 10(5) W versus 1.1 x 10(5) W with near-continuous delivery (p = 0.015).


CONCLUSIONS
No differences in complications, functional outcome, or structural outcome were found between using pulsed mode and near-continuous mode diode laser delivery for high-risk ROP. Near-continuous laser delivery, in our hands, was more time-efficient and used less total power.
Paysse
Evelyn A
EA
Cullen Eye Institute, Baylor College of Medicine, Department of Ophthalmology, Texas Children's Hospital, Houston, Texas 77030, USA. epaysse@bcm.tmc.edu
Hussein
Mohamed A W
MA
Miller
Aaron M
AM
Brady McCreery
Kathryn M
KM
Coats
David K
DK
D005260:Female; D006801:Humans; D007231:Infant, Newborn; D017075:Laser Coagulation / Q000009:adverse effects / Q000379:methods*; D054023:Lasers, Semiconductor / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D011446:Prospective Studies; D012160:Retina / Q000503:physiopathology / Q000601:surgery*; D012178:Retinopathy of Prematurity / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology