Diabetic macular oedema (DMO) is the leading cause of vision loss and disability in working-age people with diabetes mellitus. This literature review describes pathogenetic mechanisms, concepts, diagnostic techniques and capabilities of novel laser technologies in the treatment of DMO. In recent years, the role of cytokines and growth factors in retinal neurodegeneration has been actively investigated. Modern diagnostic techniques for the treatment of diabetic macular oedema, in addition to conventional techniques, include optical coherence tomography, autofluorescence and microperimetry. These techniques allow the visualization of retinal structures and its functional condition, and they can be used to detect DMO at early stages and to provide the most effective treatment. The evolution of laser technology resulted in the formation of new approaches to DMO treatment. Subthreshold micropulse laser (SML) treatment, in conjunction with conventional photocoagulation, has pronounced therapeutic effects. SML shows high selectivity towards retinal pigment epithelium while avoiding neurosensory retina injury. Owing to the chronic nature of DMO and pathogenetic mechanisms recently discovered, further elaboration of the SML technique appears to be a very promising treatment.

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PURPOSE: To perform a quantitative evaluation of smoothness of ablation on polymethylmethacrylate (PMMA) using four scanning excimer lasers available commercially for photorefractive surgery. METHODS: Ablations were done on PMMA plates with dimensions 100 x 50 x 1 mm. Four scanning excimer lasers were used, two with flying spot technology (Zeiss-Meditec MEL-70, and a Russian-made unit, Microscan) and two Nidek models with scanning slit delivery systems and an expanding iris diaphragm (EC-5000 and EC-5000 CX). Forty PMMA plates were ablated with standard -3.00-D settings using an ablation zone of 6 mm; each laser ablated 10 plates. Measurements were made in the center of each plate with the Zygo microscope, based on the principle of white light interferometry. Smoothness of ablation was characterized by three surface parameters (RMS, Ra, PV). RMS was considered the most significant parameter. RESULTS: The smoothest surface was obtained in samples produced by Zeiss-Meditec MEL-70 unit (RMS=112±23 nm), followed by the Nidek EC-5000 CX (RMS=153±12 nm), and the Microscan (RMS=181±11 nm). The smoothness of ablation produced by the Nidek EC-5000 unit (RMS=329±39 nm) was significantly less than the other three lasers (P<.01). CONCLUSIONS: Scanning excimer lasers based on flying spot technology-Zeiss-Meditec MEL-70 and Microscan, as well as the Nidek EC-5000 CX with FlexScan-created smoother ablations on PMMA plates compared to the older Nidek EC-5000 unit. [J Refract Surg 2004;20(suppl):S730-S733]

411.24 ± 126 μm to 359.86 ± 120.4 μm (p < 0.05), with a subsequent increase in the mean best-corrected visual acuity (BCVA) from 0. 52 ± 0.2 at baseline to 0.71 ± 0.2 (p < 0.05) at the 12-month follow-up. The mean central retinal sensitivity (RS) improved from 11.27 ± 3.8 dB to 13.24 ± 3.2 dB (p < 0.05). In the control group, our results showed similar improvement in respectively, p < 0.05