Skip to main content
Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology 6/2015

01.06.2015 | Retinal Disorders

Factors affecting laser power in retinal Navilas laser treatment

verfasst von: Alexandra E. Hoeh, Stefanie Pollithy, Stefan Dithmar

Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology | Ausgabe 6/2015

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To evaluate the effect of patient-associated factors on the minimum laser power needed for a mild visible burn in focal laser treatments using the 532 nm Navilas laser system.

Methods

We conducted a monocentric prospective pilot study of 58 eyes of 40 patients with diabetic macular edema. The following parameters were analysed: axial length, refraction, iris pigmentation, lens status, lens grading and densitometry, retinal and choroidal thickness and focus setting during treatment. Laser power was adjusted to produce mild, barely visible burns. Retinal laser burn size was measured 30 min after treatment.

Results

Focus setting is significantly correlated with retinal lesion size (r = 0.50, p = 0.001) and laser power (r = 0.44, p < 0.001). Axial length only correlated with laser power when the effect of focus was controlled. Phakic eyes needed more laser power than pseudophakic eyes (78.3 versus 67.2 mW, p = 0.051). No correlation of laser power with any other factor could be found.

Conclusions

Among the examined parameters, focus setting had the strongest effect on the laser power needed to produce a mild visible burn. The association of focus with laser power can be explained by the focus-dependent change of retinal spot size. Lens status (phakic versus pseudophakic patients) seems to influence laser light transmission in the examined age group.
Literatur
1.
Zurück zum Zitat Early Treatment Diabetic Retinopathy Study research group (1985) Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study report number 1. Arch Ophthalmol 103:1796–1806CrossRef Early Treatment Diabetic Retinopathy Study research group (1985) Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study report number 1. Arch Ophthalmol 103:1796–1806CrossRef
2.
Zurück zum Zitat Kernt M, Cheuteu RE, Cserhati S, Seidensticker F, Liegl RG, Lang J, Haritoglou C, Kampik A, Ulbig MW, Neubauer AS (2012) Pain and accuracy of focal laser treatment for diabetic macular edema using a retinal navigated laser (Navilas). Clin Ophthalmol 6:289–296CrossRefPubMedCentralPubMed Kernt M, Cheuteu RE, Cserhati S, Seidensticker F, Liegl RG, Lang J, Haritoglou C, Kampik A, Ulbig MW, Neubauer AS (2012) Pain and accuracy of focal laser treatment for diabetic macular edema using a retinal navigated laser (Navilas). Clin Ophthalmol 6:289–296CrossRefPubMedCentralPubMed
3.
Zurück zum Zitat Kozak I, Oster SF, Cortes MA, Dowell D, Hartmann K, Kim JS, Freeman WR (2011) Clinical evaluation and treatment accuracy in diabetic macular edema using navigated laser photocoagulator NAVILAS. Ophthalmology 118:1119–1124CrossRefPubMed Kozak I, Oster SF, Cortes MA, Dowell D, Hartmann K, Kim JS, Freeman WR (2011) Clinical evaluation and treatment accuracy in diabetic macular edema using navigated laser photocoagulator NAVILAS. Ophthalmology 118:1119–1124CrossRefPubMed
4.
Zurück zum Zitat Ansari-Shahrezaei S, Ergun E, Stur M (2006) The effect of axial length on photodynamic therapy. Am J Ophthalmol 141:699–702CrossRefPubMed Ansari-Shahrezaei S, Ergun E, Stur M (2006) The effect of axial length on photodynamic therapy. Am J Ophthalmol 141:699–702CrossRefPubMed
5.
Zurück zum Zitat Pomerantzeff O, Schepens CL (1975) Variation of energy density in argon laser photocoagulation. Arch Ophthalmol 93:1033–1035CrossRefPubMed Pomerantzeff O, Schepens CL (1975) Variation of energy density in argon laser photocoagulation. Arch Ophthalmol 93:1033–1035CrossRefPubMed
6.
Zurück zum Zitat Blumenthal EZ, Serpetopoulos CN (2000) Laser photocoagulation spot-size errors stemming from the refractive state of the surgeon’s eye. Ophthalmology 107:329–333CrossRefPubMed Blumenthal EZ, Serpetopoulos CN (2000) Laser photocoagulation spot-size errors stemming from the refractive state of the surgeon’s eye. Ophthalmology 107:329–333CrossRefPubMed
7.
Zurück zum Zitat Jain A, Blumenkranz MS, Paulus Y, Wiltberger MW, Andersen DE, Huie P, Palanker D (2008) Effect of pulse duration on size and character of the lesion in retinal photocoagulation. Arch Ophthalmol 126:78–85CrossRefPubMed Jain A, Blumenkranz MS, Paulus Y, Wiltberger MW, Andersen DE, Huie P, Palanker D (2008) Effect of pulse duration on size and character of the lesion in retinal photocoagulation. Arch Ophthalmol 126:78–85CrossRefPubMed
8.
Zurück zum Zitat Koinzer S, Schlott K, Ptaszynski L, Bever M, Kleemann S, Saeger M, Baade A, Caliebe A, Miura Y, Birngruber R, Brinkmann R, Roider J (2012) Temperature-controlled retinal photocoagulation–a step toward automated laser treatment. Invest Ophthalmol Vis Sci 53:3605–3614CrossRefPubMed Koinzer S, Schlott K, Ptaszynski L, Bever M, Kleemann S, Saeger M, Baade A, Caliebe A, Miura Y, Birngruber R, Brinkmann R, Roider J (2012) Temperature-controlled retinal photocoagulation–a step toward automated laser treatment. Invest Ophthalmol Vis Sci 53:3605–3614CrossRefPubMed
9.
Zurück zum Zitat Muqit MM, Denniss J, Nourrit V, Marcellino GR, Henson DB, Schiessl I, Stanga PE (2011) Spatial and spectral imaging of retinal laser photocoagulation burns. Invest Ophthalmol Vis Sci 52:994–1002CrossRefPubMed Muqit MM, Denniss J, Nourrit V, Marcellino GR, Henson DB, Schiessl I, Stanga PE (2011) Spatial and spectral imaging of retinal laser photocoagulation burns. Invest Ophthalmol Vis Sci 52:994–1002CrossRefPubMed
10.
Zurück zum Zitat Bennett AG, Rudnicka AR, Edgar DF (1994) Improvements on Littmann’s method of determining the size of retinal features by fundus photography. Graefes Arch Clin Exp Ophthalmol 232:361–367CrossRefPubMed Bennett AG, Rudnicka AR, Edgar DF (1994) Improvements on Littmann’s method of determining the size of retinal features by fundus photography. Graefes Arch Clin Exp Ophthalmol 232:361–367CrossRefPubMed
11.
Zurück zum Zitat Littmann H (1988) Determining the true size of an object on the fundus of the living eye. Klin Monbl Augenheilkd 192:66–67CrossRefPubMed Littmann H (1988) Determining the true size of an object on the fundus of the living eye. Klin Monbl Augenheilkd 192:66–67CrossRefPubMed
12.
Zurück zum Zitat Ansari-Shahrezaei S, Binder S, Stur M (2011) The effect of laser unit on photodynamic therapy spot size. Graefes Arch Clin Exp Ophthalmol 249:11–14CrossRefPubMed Ansari-Shahrezaei S, Binder S, Stur M (2011) The effect of laser unit on photodynamic therapy spot size. Graefes Arch Clin Exp Ophthalmol 249:11–14CrossRefPubMed
13.
Zurück zum Zitat Kondo M, Ito Y, Miyata K, Kondo N, Ishikawa K, Terasaki H (2006) Effect of axial length on laser spot size during photodynamic therapy: an experimental study in monkeys. Am J Ophthalmol 141:214–215CrossRefPubMed Kondo M, Ito Y, Miyata K, Kondo N, Ishikawa K, Terasaki H (2006) Effect of axial length on laser spot size during photodynamic therapy: an experimental study in monkeys. Am J Ophthalmol 141:214–215CrossRefPubMed
14.
Zurück zum Zitat Stur M, Ansari-Shahrezaei S (2001) The effect of axial length on laser spot size and laser irradiance. Arch Ophthalmol 119:1323–1328CrossRefPubMed Stur M, Ansari-Shahrezaei S (2001) The effect of axial length on laser spot size and laser irradiance. Arch Ophthalmol 119:1323–1328CrossRefPubMed
15.
Zurück zum Zitat Bron AJ, Vrensen GF, Koretz J, Maraini G, Harding JJ (2000) The ageing lens. Ophthalmologica 214:86–104CrossRefPubMed Bron AJ, Vrensen GF, Koretz J, Maraini G, Harding JJ (2000) The ageing lens. Ophthalmologica 214:86–104CrossRefPubMed
16.
Zurück zum Zitat Menon IA, Wakeham DC, Persad SD, Avaria M, Trope GE, Basu PK (1992) Quantitative determination of the melanin contents in ocular tissues from human blue and brown eyes. J Ocul Pharmacol 8:35–42CrossRefPubMed Menon IA, Wakeham DC, Persad SD, Avaria M, Trope GE, Basu PK (1992) Quantitative determination of the melanin contents in ocular tissues from human blue and brown eyes. J Ocul Pharmacol 8:35–42CrossRefPubMed
17.
Zurück zum Zitat Wakamatsu K, Hu D-N, McCormick SA, Ito S (2012) Characterization of melanin in human iridal and choroidal melanocytes from eyes with various colored irides. Pigment Cell Melanoma Res 21:97–105CrossRef Wakamatsu K, Hu D-N, McCormick SA, Ito S (2012) Characterization of melanin in human iridal and choroidal melanocytes from eyes with various colored irides. Pigment Cell Melanoma Res 21:97–105CrossRef
18.
Zurück zum Zitat Schmidt SY, Peisch RD (1986) Melanin concentration in normal human retinal pigment epithelium. Regional variation and age-related reduction. Invest Ophthalmol Vis Sci 27:1063–1067PubMed Schmidt SY, Peisch RD (1986) Melanin concentration in normal human retinal pigment epithelium. Regional variation and age-related reduction. Invest Ophthalmol Vis Sci 27:1063–1067PubMed
19.
Zurück zum Zitat Kim M, Kim SS, Kwon HJ, Koh HJ, Lee SC (2012) Association between choroidal thickness and ocular perfusion pressure in young, healthy subjects: enhanced depth imaging optical coherence tomography study. Invest Ophthalmol Vis Sci 53:7710–7717CrossRefPubMed Kim M, Kim SS, Kwon HJ, Koh HJ, Lee SC (2012) Association between choroidal thickness and ocular perfusion pressure in young, healthy subjects: enhanced depth imaging optical coherence tomography study. Invest Ophthalmol Vis Sci 53:7710–7717CrossRefPubMed
20.
Zurück zum Zitat Welch AJ, Wissler EH, Priebe LA (1980) Significance of blood flow in calculations of temperature in laser irradiated tissue. IEEE Trans Biomed Eng 27:164–166CrossRefPubMed Welch AJ, Wissler EH, Priebe LA (1980) Significance of blood flow in calculations of temperature in laser irradiated tissue. IEEE Trans Biomed Eng 27:164–166CrossRefPubMed
21.
Zurück zum Zitat Birngruber R, Weinberg W, Gabel V-P, Kain H (1980) Der Einfluß der aderhautdurchblutung auf die entstehung von thermischen läsionen am augenhintergrund. Ber Dtsch Ophthalmol Ges 77:705–710 Birngruber R, Weinberg W, Gabel V-P, Kain H (1980) Der Einfluß der aderhautdurchblutung auf die entstehung von thermischen läsionen am augenhintergrund. Ber Dtsch Ophthalmol Ges 77:705–710
22.
Zurück zum Zitat Geeraets WJ, Williams R, Chan G, Ham WT, Guerry D, Schmidt FH (1962) The relative absorption of thermal energy in retina and choroid. Invest Ophthalmol 1:340–347PubMed Geeraets WJ, Williams R, Chan G, Ham WT, Guerry D, Schmidt FH (1962) The relative absorption of thermal energy in retina and choroid. Invest Ophthalmol 1:340–347PubMed
23.
Zurück zum Zitat Singh A, Stewart JM (2009) Pathophysiology of diabetic macular edema. Int Ophthalmol Clin 49:1–11CrossRefPubMed Singh A, Stewart JM (2009) Pathophysiology of diabetic macular edema. Int Ophthalmol Clin 49:1–11CrossRefPubMed
Metadaten
Titel
Factors affecting laser power in retinal Navilas laser treatment
verfasst von
Alexandra E. Hoeh
Stefanie Pollithy
Stefan Dithmar
Publikationsdatum
01.06.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Graefe's Archive for Clinical and Experimental Ophthalmology / Ausgabe 6/2015
Print ISSN: 0721-832X
Elektronische ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-014-2774-4

Weitere Artikel der Ausgabe 6/2015

Graefe's Archive for Clinical and Experimental Ophthalmology 6/2015 Zur Ausgabe

Neu im Fachgebiet Augenheilkunde

Ophthalmika in der Schwangerschaft

Die Verwendung von Ophthalmika in der Schwangerschaft und Stillzeit stellt immer eine Off-label-Anwendung dar. Ein Einsatz von Arzneimitteln muss daher besonders sorgfältig auf sein Risiko-Nutzen-Verhältnis bewertet werden. In der vorliegenden …

Operative Therapie und Keimnachweis bei endogener Endophthalmitis

Vitrektomie Originalie

Die endogene Endophthalmitis ist eine hämatogen fortgeleitete, bakterielle oder fungale Infektion, die über choroidale oder retinale Gefäße in den Augapfel eingeschwemmt wird [ 1 – 3 ]. Von dort infiltrieren die Keime in die Netzhaut, den …

Bakterielle endogene Endophthalmitis

Vitrektomie Leitthema

Eine endogene Endophthalmitis stellt einen ophthalmologischen Notfall dar, der umgehender Diagnostik und Therapie bedarf. Es sollte mit geeigneten Methoden, wie beispielsweise dem Freiburger Endophthalmitis-Set, ein Keimnachweis erfolgen. Bei der …

So erreichen Sie eine bestmögliche Wundheilung der Kornea

Die bestmögliche Wundheilung der Kornea, insbesondere ohne die Ausbildung von lichtstreuenden Narben, ist oberstes Gebot, um einer dauerhaften Schädigung der Hornhaut frühzeitig entgegenzuwirken und die Funktion des Auges zu erhalten.   

Update Augenheilkunde

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.