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Surgical Technique | Sep 2012 Surgeon's Corner

Utility of Large Spot Binocular Indirect Laser Delivery for Peripheral Photocoagulation Therapy in Children

Saranya C. Balasubramaniam, BA; Brian G. Mohney, MD; Genie M. Bang, MD; Thomas P. Link, BA; Jose S. Pulido, MD, MS, MPH, MBA

Arch Ophthalmol. 2012;130(9):1213-1217. doi:10.1001/archophthalmol.2012.1978.

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ABSTRACT

The purpose of this article is to demonstrate the utility of the large spot size (LSS) setting using a binocular laser indirect delivery system for peripheral ablation in children. One patient with bilateral retinopathy of prematurity received photocoagulation with standard spot size burns placed adjacently to LSS burns. Using a pixel analysis program called Image J on the Retcam picture, the areas of each retinal spot size were determined in units of pixels, giving a standard spot range of 805 to 1294 pixels and LSS range of 1699 to 2311 pixels. Additionally, fluence was calculated using theoretical retinal areas produced by each spot size: the standard spot setting was 462 mJ/mm² and the LSS setting was 104 mJ/mm². For eyes with retinopathy of prematurity, our study shows that LSS laser indirect delivery halves the number of spots required for treatment and reduces fluence by almost one-quarter, producing more uniform spots.

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Figure 1. Retcam (Clarity Medical Systems) photograph of adjacent spot size treatment delivered to patient 4. Large spot size photocoagulation spots (left) appear to be more uniform in shape and size than those delivered with the standard spot size setting (right).

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Figure 2. Image J (National Institutes of Health) analysis of Figure 1 can quantify the difference in pixel area of large spot size photocoagulation spots (1669-2311 pixels) and standard photocoagulation spots (805-1294 pixels), as listed in Table 3.

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Balasubramaniam SC, Mohney BG, Bang GM, Link TP, Pulido JS. Utility of Large Spot Binocular Indirect Laser Delivery for Peripheral Photocoagulation Therapy in Children. Arch Ophthalmol. 2012;130(9):1213-1217. doi:10.1001/archophthalmol.2012.1978.

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Utility of Large Spot Binocular Indirect Laser Delivery for Peripheral Photocoagulation Therapy in Children

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