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. 1986;84:967–1003.

Red krypton and blue-green argon panretinal laser photocoagulation for proliferative diabetic retinopathy: a laboratory and clinical comparison.

G W Blankenship
PMCID: PMC1298756  PMID: 2438841

Abstract

The effects of PRP with red krypton laser are essentially identical to those produced with blue-green argon laser. Burns of the rabbit retina produced with these two different lasers are almost the same. In a prospective and randomized clinical trial of proliferative diabetic retinopathy treatment there was no significant difference between PRP using these two different lasers. The characteristic changes of rabbit fundi 3, 7, and 30 days after PRP with red krypton laser were almost the same as those following blue-green argon laser. Both types of treatment frequently produced small vitreous hemorrhages and exudative retinal detachments, but choroidal thickening occurred more frequently with argon treatment. These changes were transient and had resolved within 30 days of treatment. The microscopic changes consisted of pigment epithelial disruption with pigment migration into the retina, heat coagulation of the photoreceptors, disruption of the outer and inner nuclear layers with atrophy of the nuclei, and temporary swelling of the nerve fiber layer. The untreated retina and choroid between burns was not involved and appeared normal at each period. Thirty days after treatment, the scarring produced by these two types of burns was identical. Seventy-one eyes with proliferative diabetic retinopathy having three or four retinopathy risk factors were treated with panretinal laser photocoagulation, and followed in a prospective study for 6 months. Thirty-six eyes were randomly selected for blue-green argon treatment, and 35 were randomly selected for red krypton treatment. The incidence of undesired side effects during the first 2 weeks following treatment was almost identical between the two groups. However, by 1 month the majority of eyes in both groups had visual acuities equal to or better than the pretreatment acuities and complete regression of NVD. Six months after treatment, the majority of eyes in both groups continued to have visual acuities equal to or better than the pretreatment acuities with fewer cases having larger losses of vision in the krypton treated group. Loss of peripheral visual field was equal with the two types of treatment having a minimal decrease with the IV-4e isopter, but substantial loss with the I-4e isopter. Additional vitreous hemorrhage rarely occurred in either group, but was slightly more frequent in those treated with krypton. Complete regression was accomplished in most eyes with pretreatment disc and/or NVE in both groups, but persistence of neovascularization was more frequent in those treated with krypton. Overall, the wavelength used seemingly had little effect on the result.(ABSTRACT TRUNCATED AT 400 WORDS)

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Apple D. J., Goldberg M. F., Wyhinny G. Histopathology and ultrastructure of the argon laser lesion in human retinal and choroidal vasculatures. Am J Ophthalmol. 1973 Apr;75(4):595–609. doi: 10.1016/0002-9394(73)90812-x. [DOI] [PubMed] [Google Scholar]
  2. BRAZIL N. M., REZENDE J. [The role of photocoagulation in ophthalmology]. Bull Mem Soc Fr Ophtalmol. 1961;74:699–710. [PubMed] [Google Scholar]
  3. Barr C. C. Estimation of the maximum number of argon laser burns possible in panretinal photocoagulation. Am J Ophthalmol. 1984 Jun;97(6):697–703. doi: 10.1016/0002-9394(84)90500-2. [DOI] [PubMed] [Google Scholar]
  4. Blankenship G. W. Panretinal laser photocoagulation with wide-angle fundus contact lens. Ann Ophthalmol. 1982 Apr;14(4):362–363. [PubMed] [Google Scholar]
  5. Bowbyes J. A., Hamilton A. M., Bird A. C., Blach R. K., Marshall J., Kohner E. M. The argon laser-the effect on retinal tissues and its clinical applications. Trans Ophthalmol Soc U K. 1973;93(0):439–453. [PubMed] [Google Scholar]
  6. CAMPBELL C. J., KOESTER C. J., CURTICE V., NOYORI K. S., RITTLER M. C. CLINICAL STUDIES IN LASER PHOTOCOAGULATION. Arch Ophthalmol. 1965 Jul;74:57–65. doi: 10.1001/archopht.1965.00970040059014. [DOI] [PubMed] [Google Scholar]
  7. Constantinides G., Hache J. C., François P. Aspect fonctionnel de la pan-photocoagulation retinienne. Bull Soc Ophtalmol Fr. 1978 Aug-Sep;78(8-9):603–605. [PubMed] [Google Scholar]
  8. Doft B. H., Blankenship G. W. Single versus multiple treatment sessions of argon laser panretinal photocoagulation for proliferative diabetic retinopathy. Ophthalmology. 1982 Jul;89(7):772–779. doi: 10.1016/s0161-6420(82)34734-x. [DOI] [PubMed] [Google Scholar]
  9. Frank R. N. Visual fields and electroretinography following extensive photocoagulation. Arch Ophthalmol. 1975 Aug;93(8):591–598. doi: 10.1001/archopht.1975.01010020575004. [DOI] [PubMed] [Google Scholar]
  10. Gelatt K. N. Animal models for glaucoma. Invest Ophthalmol Vis Sci. 1977 Jul;16(7):592–596. [PubMed] [Google Scholar]
  11. Huamonte F. U., Peyman G. A., Goldberg M. F., Locketz A. Immediate fundus complications after retinal scatter photocoagulation. I. Clinical picture and pathogenesis. Ophthalmic Surg. 1976 Spring;7(1):88–99. [PubMed] [Google Scholar]
  12. L'Esperance F. A., Jr The ocular histopathologic effect of krypton and argon laser radiation. Am J Ophthalmol. 1969 Aug;68(2):263–273. doi: 10.1016/0002-9394(69)94069-0. [DOI] [PubMed] [Google Scholar]
  13. L'Espereance F. A., Jr The effect of laser radiation on the retinal vasculature; animal and clinical studies. Arch Ophthalmol. 1965 Dec;74(6):752–759. doi: 10.1001/archopht.1965.00970040754004. [DOI] [PubMed] [Google Scholar]
  14. Marshall J., Bird A. C. A comparative histopathological study of argon and krypton laser irradiations of the human retina. Br J Ophthalmol. 1979 Oct;63(10):657–668. doi: 10.1136/bjo.63.10.657. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Mensher J. H. Anterior chamber depth alteration after retinal photocoagulation. Arch Ophthalmol. 1977 Jan;95(1):113–116. doi: 10.1001/archopht.1977.04450010113011. [DOI] [PubMed] [Google Scholar]
  16. Okun E., Johnston G. P., Boniuk I., Arribas N. P., Escoffery R. F., Grand M. G. Xenon arc photocoagulation of proliferative diabetic retinopathy. A review of 2688 consecutive eyes in the format of the Diabetic Retinopathy Study. Ophthalmology. 1984 Dec;91(12):1458–1463. doi: 10.1016/s0161-6420(84)34122-7. [DOI] [PubMed] [Google Scholar]
  17. Okun E. The effectiveness of photocoagulation in the therapy of proliferative diabetic retinopathy (PDR). (A controlled study in 50 patients). Trans Am Acad Ophthalmol Otolaryngol. 1968 Mar-Apr;72(2):246–252. [PubMed] [Google Scholar]
  18. Peyman G. A., Li M., Yoneya S., Goldberg M. F., Raichand M. Fundus photocoagulation with the argon and krypton lasers: a comparative study. Ophthalmic Surg. 1981 Jul;12(7):481–490. [PubMed] [Google Scholar]
  19. Phelps C. D. Angle-closure glaucoma secondary to ciliary body swelling. Arch Ophthalmol. 1974 Oct;92(4):287–290. doi: 10.1001/archopht.1974.01010010297004. [DOI] [PubMed] [Google Scholar]
  20. Powell J. O., Bresnick G. H., Yanoff M., Frisch G. D., Chester J. E. Ocular effects of argon laser radiation. II. Histopathology of chorioretinal lesions. Am J Ophthalmol. 1971 Jun;71(6):1267–1276. doi: 10.1016/0002-9394(71)90974-3. [DOI] [PubMed] [Google Scholar]
  21. Schulenburg W. E., Hamilton A. M., Blach R. K. A comparative study of argon laser and krypton laser in the treatment of diabetic optic disc neovascularisation. Br J Ophthalmol. 1979 Jun;63(6):412–417. doi: 10.1136/bjo.63.6.412. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Singerman L. J. Red krypton laser therapy of macular and retinal vascular diseases. Retina. 1982;2(1):15–28. doi: 10.1097/00006982-198200210-00003. [DOI] [PubMed] [Google Scholar]
  23. Smiddy W. E., Fine S. L., Green W. R., Glaser B. M. Clinicopathologic correlation of krypton red, argon blue-green, and argon green laser photocoagulation in the human fundus. Retina. 1984 Winter-Spring;4(1):15–21. doi: 10.1097/00006982-198400410-00004. [DOI] [PubMed] [Google Scholar]
  24. Smiddy W. E., Fine S. L., Quigley H. A., Hohman R. M., Addicks E. A. Comparison of krypton and argon laser photocoagulation. Results of stimulated clinical treatment of primate retina. Arch Ophthalmol. 1984 Jul;102(7):1086–1092. doi: 10.1001/archopht.1984.01040030880039. [DOI] [PubMed] [Google Scholar]
  25. WETZIG P. C., WORLTON J. T. TREATMENT OF DIABETIC RETINOPATHY BY LIGHT-COAGULATION: A PRELIMINARY STUDY. Br J Ophthalmol. 1963 Sep;47:539–541. doi: 10.1136/bjo.47.9.539. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Wallow I. H., Davis M. D. Clinicopathologic correlation of xenon arc and argon laser photocoagulation. Procedure in human diabetic eyes. Arch Ophthalmol. 1979 Dec;97(12):2308–2315. doi: 10.1001/archopht.1979.01020020524002. [DOI] [PubMed] [Google Scholar]
  27. Wallow I. H. Long-term changes in photocoagulation burns. Dev Ophthalmol. 1981;2:318–327. doi: 10.1159/000395341. [DOI] [PubMed] [Google Scholar]
  28. ZARET M. M., BREININ G. M., SCHMIDT H., RIPPS H., SIEGEL I. M., SOLON L. R. Ocular lesions produced by an optical maser (laser). Science. 1961 Nov 10;134(3489):1525–1526. doi: 10.1126/science.134.3489.1525. [DOI] [PubMed] [Google Scholar]
  29. Zweng H. C., Little H. L., Peabody R. R. Further observations on argon laser photocoagulation of diabetic retinopathy. Trans Am Acad Ophthalmol Otolaryngol. 1972 Jul-Aug;76(4):990–1004. [PubMed] [Google Scholar]

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