Pilot Trial of Transscleral Diode Laser Retinopexy in Retinal Detachment Surgery-Reply

In reply  We certainly appreciate Schubert's interest in and comments about our report on a pilot trial of transscleral diode laser retinopexy.In response to his observations about treatment efficacy, we would point out that the energy levels required to achieve burns transsclerally at the level of the retina are not really comparable with those needed for transpupillary photocoagulation for several reasons. First, with any type of transscleral laser treatment, scattering of energy occurs at the level of the sclera. With a near infrared diode laser, only about 50% to 60% of the laser energy (depending on the degree of scleral compression) actually gets through the sclera.¹ This is of course not the case in transpupillary laser treatment in which virtually all the energy gets through the clear media. Thus, the energy levels shown in our tables reflect the fact that only 50% or so of the energy is