Navigated Pattern Laser System versus Single-Spot Laser System for Postoperative 360-Degree Laser Retinopexy

Abstract

Purpose. To compare three 360°-laser retinopexy (LRP) approaches (using navigated pattern laser system, single-spot slit-lamp (SL) laser delivery, and single-spot indirect ophthalmoscope (IO) laser delivery) in regard to procedure duration, procedural pain score, technical difficulties, and the ability to achieve surgical goals. Material and Methods. Eighty-six rhegmatogenous retinal detachment patients (86 eyes) were included in this prospective randomized study. The mean procedural time, procedural pain score (using 4-point Verbal Rating Scale), number of laser burns, and achievement of the surgical goals were compared between three groups (pattern LRP (Navilas® laser system), 36 patients; SL-LRP, 28 patients; and IO-LRP, 22 patients). Results. In the pattern LRP group, the amount of time needed for LRP and pain level were statistically significantly lower, whereas the number of applied laser burns was higher compared to those in the SL-LRP group and in the IO-LRP group. In the pattern LRP, SL-LRP, and IO-LRP groups, surgical goals were fully achieved in 28 (77.8%), 17 (60.7%), and 13 patients (59.1%), respectively (p > 0.05). Conclusion. The navigated pattern approach allows improving the treatment time and pain in postoperative 360° LRP. Moreover, 360° pattern LRP is at least as effective in achieving the surgical goal as the conventional (slit-lamp or indirect ophthalmoscope) approaches with a single-spot laser.

Safety and efficacy of the use of navigated retinal laser as a method of laser retinopexy in the treatment of symptomatic retinal tears

“…Furthermore, the study has shown that this laser can effectively deliver treatment quickly (median 200 s) and by a range of different laser operators. These results are comparable to previous studies using conventional laser methods [9]. In this study, the treatment was successful for 95.7% of patients with a single laser session and 100% of patients with two laser sessions.…”

“…A second potential limitation was that this study had several different laser users. The clinical efficacy of laser is known to vary based on laser user [9]. However, we were not able to perform sub-group analysis and compare the data within the operator groups because the sample sizes and complication rates were too small.…”

“…Successful use of this laser technique has been demonstrated for macular conditions where the retinal treatment maps improve the safety of laser delivery close to the fovea [7,8]. Navigated laser has also been shown to be effective in more peripheral laser treatments such as postoperative 360-degree laser retinopexy and pan-retinal photocoagulation [9,10]. It offers several potential benefits, such as improved accuracy by live tracking, decreased treatment times and improved safety due to the ability to digitally exclude areas from treatment.…”

Recurrences and Macular Complications after Perfluorocarbon-Liquid-Free Vitrectomy for Primary Rhegmatogenous Retinal Detachment

“…Moreover, the drawbacks of intraoperative 360° laser retinopexy include increased total operating time and the need for scleral depression to coagulate peripheral retinal locations. A navigated pattern laser (Navilas) could also have been used postoperatively [ 19 ]. A higher rate of RRD recurrence was observed in eyes filled with silicone oil, but this could also be attributed to a selection bias, as silicone oil is typically used in eyes perceived to be at a higher risk of re-detachment.…”

Wide-Field Imaging with NAVILAS Laser System

“…Однако опцией включения в оптическую ось дополнительных линз обладает лазерная система NAVILAS. Эта система включает сканирующий лазерный офтальмоскоп, работающий в инфракрасном и полихромном режиме, совместима с различными широкопольными контактными линзами и применяется для выполнения лазерных вмешательств как на периферии, так и в центре глазного дна [5,6]. Поскольку система разработана для использования с линзой, позволяющей визуализировать до 80° глазного дна, ее возможности при комбинации с линзами с бóльшим углом обзора не известны.…”