Pulsed mode versus near-continuous mode delivery of diode laser photocoagulation for high-risk retinopathy of prematurity

J AAPOS. 2007 Aug;11(4):388-92. doi: 10.1016/j.jaapos.2006.11.011. Epub 2007 Feb 15.


Objective: To compare structural and functional outcomes and efficiency of diode laser photocoagulation for retinopathy of prematurity (ROP) when delivered in a pulsed mode versus a near-continuous mode.

Methods: A retrospective study was conducted of 138 patients who underwent diode laser photocoagulation for threshold ROP using either pulsed or near-continuous delivery. Laser-related complications and structural and functional outcomes were analyzed. Prospectively, time efficiency and total energy used were evaluated in nine infants with bilateral symmetric high-risk prethreshold ROP in which one eye of each infant was randomized to pulsed and the fellow eye to near-continuous delivery.

Results: There was no significant difference between groups with regards to prevalence of posterior disease (Zone 1 or posterior Zone 2) (p = 0.11), postoperative vitreous haze (p = 0.60), postoperative complications (p = 0.38), retinal detachment (p = 0.90), strabismus (p = 0.73), amblyopia (p = 0.69), or refractive error (p = 0.95). Mean time for treatment was 23 minutes using pulsed delivery versus 14 minutes per eye with near-continuous delivery (p < 0.001). The mean total power used per eye with pulsed mode delivery was 1.5 x 10(5) W versus 1.1 x 10(5) W with near-continuous delivery (p = 0.015).

Conclusions: No differences in complications, functional outcome, or structural outcome were found between using pulsed mode and near-continuous mode diode laser delivery for high-risk ROP. Near-continuous laser delivery, in our hands, was more time-efficient and used less total power.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Female
  • Humans
  • Infant, Newborn
  • Laser Coagulation / adverse effects
  • Laser Coagulation / methods*
  • Lasers, Semiconductor / adverse effects
  • Lasers, Semiconductor / therapeutic use*
  • Male
  • Prospective Studies
  • Retina / physiopathology
  • Retina / surgery*
  • Retinopathy of Prematurity / surgery*
  • Retrospective Studies
  • Treatment Outcome
  • Visual Acuity / physiology