Experience with the Pascal® photocoagulator: An analysis of over 1200 laser procedures with regard to parameter refinement

Saumil Sheth, Paolo Lanzetta, Daniele Veritti, Ilaria Zucchiatti, Carola Savorgnani, Francesco Bandello

Research output: Contribution to journalArticlepeer-review

Abstract

Aim: To systematically refine and recommend parameter settings of spot size, power, and treatment duration using the Pascal® photocoagulator, a multi-spot, semi-automated, short-duration laser system. Materials and Methods: A retrospective consecutive series with 752 Caucasian eyes and 1242 laser procedures over two years were grouped into, (1) 374 macular focal / grid photocoagulation (FP), (2), 666 panretinal photocoagulation (PRP), and (3) 202 barrage photocoagulation (BP). Parameters for power, duration, spot number, and spot size were recorded for every group. Results: Power parameters for all groups showed a non-gaussian distribution; FP group, median 190 mW, range 100 - 950 mW, and PRP group, median 800 mW, range 100 - 2000 mW. On subgroup comparison, for similar spot size, as treatment duration decreased, the power required increased, albeit in a much lesser proportion than that given by energy = power x time. Most frequently used patterns were single spot (89% of cases) in FP, 5 × 5 box (72%) in PRP, and 2 × 2 box (78%) in BP. Spot diameters as high as ≈ 700 m on retina were given in the PRP group. Single session PRP was attempted in six eyes with a median spot count of 3500. Conclusion: Overall, due to the small duration of its pulse, the Pascal® photocoagulator tends to use higher powers, although much lower cumulative energies, than those used in a conventional laser. The consequent lesser heat dissipation, especially lateral, can allow one to use relatively larger spot sizes and give more closely spaced burns, without incurring significant side effects.

Original languageEnglish
Pages (from-to)87-91
Number of pages5
JournalIndian Journal of Ophthalmology
Volume59
Issue number2
DOIs
Publication statusPublished - Mar 2011

Keywords

  • Barrage photocoagulation
  • focal photocoagulation
  • laser power
  • laser spot size
  • laser treatment duration
  • panretinal photocoagulation
  • pascal® photocoagulation

ASJC Scopus subject areas

  • Ophthalmology

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