COMPARATIVE EVALUATION OF ANTERIOR SEGMENT OPTICAL COHERENCE TOMOGRAPHY, ULTRASOUND BIOMICROSCOPY, AND INTRAOCULAR PRESSURE CHANGES AFTER PANRETINAL PHOTOCOAGULATION BY PASCAL AND CONVENTIONAL LASER.
Lata Suman, Venkatesh Pradeep, Temkar Shreyas, Selvan Harathy, Gupta Viney, Dada Tanuj, Upadhyay Ashish D, Sihota Ramanjit
AI Summary
PASCAL and conventional PRP both raised IOP and caused ciliary effusion/angle narrowing, with conventional PRP showing more angle changes. Monitoring IOP and considering glaucoma meds post-PRP is crucial.
Abstract
Purpose
To compare intraocular pressure, anterior segment optical coherence tomography, and ultrasound biomicroscopy parameters over 3 months after panretinal photocoagulation (PRP) for proliferative diabetic retinopathy after 1 of 2 sittings by conventional laser (half PRP) and a single sitting of Pattern Scan Laser (PASCAL) PRP.
Methods
This was a prospective, randomized, interventional study. All tests were performed at baseline, and at 1, 6, and 24 hours, and 1, 4, 8, and 12 weeks after PRP.
Results
The intraocular pressure at 1 hour and 6 hours after PRP was significantly raised in both groups. Mean intraocular pressure was 21.17 ± 4.01 mmHg after PASCAL and 17.48 ± 3 mmHg after conventional laser at 1 hour, P < 0.001. On anterior segment optical coherence tomography, conventional laser PRP caused a more significant narrowing of angle-opening distance (AOD750) and trabecular-iris space area (TISA 500), P = 0.03 and 0.04, respectively, on Day 1. Ultrasound biomicroscopy showed a significantly narrow angle in both groups on Day 1. A significant increase in ciliary body thickness was observed in both groups, with 57.1% of PASCAL and 100% of conventionally treated eyes showing ciliary effusion on Day 1 that decreased but persisted for the next 3 months.
Conclusion
Performing PRP in sittings, prescribing previous glaucoma medications in patients at risk, and recording intraocular pressure an hour after the PRP could decrease complications.
MeSH Terms
Shields Classification
Key Concepts5
The intraocular pressure at 1 hour and 6 hours after panretinal photocoagulation (PRP) was significantly raised in both the PASCAL and conventional laser groups in a prospective, randomized, interventional study.
Mean intraocular pressure was 21.17 ± 4.01 mmHg after PASCAL panretinal photocoagulation (PRP) and 17.48 ± 3 mmHg after conventional laser PRP at 1 hour, with P < 0.001, in a prospective, randomized, interventional study.
On anterior segment optical coherence tomography, conventional laser panretinal photocoagulation (PRP) caused a more significant narrowing of angle-opening distance (AOD750) (P = 0.03) and trabecular-iris space area (TISA 500) (P = 0.04) on Day 1 compared to PASCAL laser PRP, in a prospective, randomized, interventional study.
Ultrasound biomicroscopy showed a significantly narrow angle in both PASCAL and conventional laser panretinal photocoagulation (PRP) groups on Day 1, and a significant increase in ciliary body thickness was observed in both groups, with 57.1% of PASCAL and 100% of conventionally treated eyes showing ciliary effusion on Day 1 that decreased but persisted for the next 3 months, in a prospective, randomized, interventional study.
Performing panretinal photocoagulation (PRP) in sittings, prescribing previous glaucoma medications in patients at risk, and recording intraocular pressure an hour after the PRP could decrease complications.
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