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Comparison and Optimizing the Methods of Laser Treatment in Patients with Diabetic Retinopathy
Savitch A., Imshenetskaya T.,
Belorussian State Medical University, Department of Ophthalmology, Republican Center for Reconstructive Eye Microsurgery (Minsk)
The aim of the study was to evaluate the effect of laser treatment both with sever nonproliferative and proliferative diabetic retinopathy (NPDR and PDR), using only argon laser (ALC) with wave length - 476, 5 - 529 nm and the combination of above mentioned laser and diode laser with wave length 810 nm (DALC).
Materials and methods: Panretinal photocoagulation was performed on 91 patients (152 eyes) in age from 22 to 74 years. All our patients received courses medical therapy of the diabetes and didn't undergo previous laser treatment. Follow - up was documented by best - corrected visual acuity, fundus photography, fluorescein angiography and visual fields. Mean duration of follow - up was 18 - 24 months. The first group of patients, consisting of 44 patients (68 eyes) was treated by traditional method of panretinal ALC by a blue - green Argon Laser "Visulas - II" (Zeiss). The second group - 47 patients (74 eyes) was underwent diode laser photocoagulation by diode laser DC - 3000 Nidec on the periphery of fundus (1 stage) and Argon "Visulas Argon - II" (Zeiss) on the posterior pole (2 stage). According to the received data we observed invariability or improvement of visual acuity, stable data of visual fields measuring in 137 eyes (90,1 %). According to ultrasound A/B - scanning data we noticed 50,6% cases of partially posterior vitreous detachment in eyes with proliferative diabetic retinopathy. In second group we received more stable data (95, 6%) in treatment both INDD and IDD in cases of diabetic macular edema and subretinal hemorrhage associated with choroidal neovascularization.
Conclusions: Panretinal photocoagulation for sever nonproliferative and proliferative diabetic retinopathy (NPDR and PDR), using the combine approach (argon and diode laser - DALC) shows more effective and stable results as using the argon system.