Pulsed mode and near-continuous mode photocoagulation similarly effective for ROP

Both pulsed mode and near-continuous mode diode laser photocoagulation are similarly effective for treating infants with high-risk retinopathy of prematurity, a retrospective study by researchers in Houston shows. However, near-continuous laser delivery was more time-efficient and used less total power, the study authors noted.

Evelyn A. Paysse

Evelyn A. Paysse, MD, and colleagues at Texas Children's Hospital compared the laser-related complications and structural and functional outcomes between the two laser delivery modes in 138 infants with threshold retinopathy of prematurity (ROP).

The researchers also prospectively compared time efficiency and total energy between the two modes in nine infants with bilateral symmetric prethreshold ROP. In these infants, investigators randomly assigned one eye of each child to receive pulsed mode photocoagulation; the contralateral eye received near-continuous mode laser treatment, according to the study.

The researchers found that both groups had a similar prevalence of posterior disease. Additionally, both treatment groups had a similar incidence of postoperative vitreous haze, postoperative complications, retinal detachment, strabismus, amblyopia and refractive errors, the authors reported.

However, performing pulsed mode photocoagulation took significantly longer, requiring an average of 23 minutes per eye vs. 14 minutes for near-continuous mode laser delivery (P < .001).

The mean total power used per eye was also significantly higher for pulsed mode laser delivery. Total power averaged 1.5 × 10⁵ W for pulsed mode vs. 1.1 × 10⁵ W for near-continuous delivery (P = .015), the authors reported.

"Near-continuous laser delivery, in our hands, was more time-efficient and used less total power," they said.

The study is published in the August issue of Journal of the American Association for Pediatric Ophthalmology and Strabismus.