Manchester Royal Eye Hospital, Manchester, UK
Acta Ophthalmol. 2012 Mar;90(2):155-61. doi: 10.1111/j.1755-3768.2009.01854.x. Epub 2010 Feb 16.
To establish safe laser parameter standards for 10-30 ms Pascal(®) laser in clinical practice and to evaluate clinical and visual outcomes using this 532-nm multi-spot photocoagulation system.
Retrospective observational case series of 313 patients treated between 2006 and 2008. Evaluation of eight groups: A - panretinal photocoagulation (PRP) for proliferative diabetic retinopathy (PDR); B - focal laser treatment for clinically significant diabetic macular oedema; C - grid laser for diffuse diabetic macular oedema; D - sector PRP for ischaemic branch retinal vein occlusions (I-BRVO); E - full PRP for ischaemic central retinal vein occlusions (I-CRVO); F - macular laser treatment for macular oedema secondary to non-ischaemic BRVO; G - full PRP for rubeosis iridis and/or neovascular glaucoma (NVG) secondary to I-BRVO, I - CRVO or PDR; H - laser retinopexy for retinal breaks/degenerations.
Mean LogMAR visual acuity for all procedures improved postlaser (p = 0.065), and laser prevented visual loss in 85% eyes. Topical anaesthesia was only required. At mean follow-up of 5 months, 72% procedures had a successful clinical outcome. Significantly higher powers were required for PRP using Pascal(®) compared to conventional laser (p = 0.001) in PDR, I-BRVO, I-CRVO and NVG. Sixty-seven per cent of patients (15/20) were successfully treated with single-session 20-ms PRP using a mean 1952 burns. There were no laser-associated adverse effects or ocular complications associated with multi-spot PRP or macular Pascal(®) arrays.
The clinical efficacy using 10- to 30-ms pulse duration Pascal(®) laser is comparable to conventional standard protocols used for the treatment of vascular retinal disorders. Higher power, 10- to 30-ms pulse duration laser may be safely and effectively used in clinical practice.
为了在临床实践中为 10-30ms 的帕斯卡（Pascal(®)）激光建立安全的激光参数标准，并使用这种 532nm 多点光凝系统评估临床和视觉效果。
回顾性观察性病例系列，共纳入 2006 年至 2008 年间治疗的 313 名患者。评估了八个组别：A-全视网膜光凝（PRP）治疗增殖性糖尿病视网膜病变（PDR）；B-局灶激光治疗有临床意义的糖尿病黄斑水肿；C-格栅激光治疗弥漫性糖尿病黄斑水肿；D-缺血性分支视网膜静脉阻塞（I-BRVO）的扇形 PRP；E-缺血性中央视网膜静脉阻塞（I-CRVO）的全 PRP；F-非缺血性 BRVO、I-CRVO 或 PDR 引起的黄斑水肿的黄斑激光治疗；G-虹膜新生血管和/或新生血管性青光眼（NVG）继发于 I-BRVO、I-CRVO 或 PDR 的全 PRP；H-视网膜裂孔/变性的激光视网膜固定术。
所有手术的平均 LogMAR 视力在激光治疗后均有所提高（p = 0.065），激光预防了 85%的眼睛视力下降。仅需要局部麻醉。在平均 5 个月的随访中，72%的手术有成功的临床效果。与传统激光相比，PDR、I-BRVO、I-CRVO 和 NVG 中使用帕斯卡（Pascal(®)）进行 PRP 需要更高的功率（p = 0.001）。20%的患者（15/20）成功接受了单次 20ms PRP 治疗，平均使用 1952 个光斑。使用多靶点 PRP 或黄斑帕斯卡（Pascal(®)）阵列没有与激光相关的不良反应或眼部并发症。
使用 10-30ms 脉冲持续时间的帕斯卡（Pascal(®)）激光的临床疗效与用于治疗血管性视网膜疾病的传统标准方案相当。更高的功率，10-30ms 脉冲持续时间的激光可能可以安全有效地用于临床实践。
