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Review
. 2021 Mar 2:15:953-971.
doi: 10.2147/OPTH.S294227. eCollection 2021.

Comparison of Pain Scores Among Patients Undergoing Conventional and Novel Panretinal Photocoagulation for Diabetic Retinopathy: A Systematic Review

Corrina P Azarcon  1 , Jose Carlo M Artiaga  2   3
Affiliations
Review

Comparison of Pain Scores Among Patients Undergoing Conventional and Novel Panretinal Photocoagulation for Diabetic Retinopathy: A Systematic Review

Corrina P Azarcon et al. Clin Ophthalmol. .

Abstract

Purpose: To summarize key findings from a systematic review focusing on pain as an adverse outcome of panretinal photocoagulation (PRP) among patients with diabetic retinopathy.

Design: Systematic review.

Methods: We systematically searched articles in major databases from July to September 2020. Studies that compared pain outcomes of PRP among diabetic patients who underwent conventional single-spot laser (SSL), conventional multi-spot laser (MSL), and/or novel navigated laser (NNL) were included. The Cochrane RoB 2 tool and ROBINS-I tool were used to evaluate the risk of bias of the included randomized controlled trials (RCTs) and controlled clinical trials (CCTs), respectively.

Results: We included 13 RCTs and 4 CCTs. Thirteen studies were included for Comparison 1 (Conventional SSL versus Conventional MSL), 3 studies were included for Comparison 2 (NNL versus Conventional MSL), and 3 studies were included for Comparison 3 (NNL versus Conventional SSL). A total of 783 patients and 1961 eyes were included in this review. The review showed that NNL yielded the lowest pain scores, followed by conventional MSL, then by conventional SSL.

Conclusion: This review summarizes findings of multiple studies that reported pain as an adverse outcome of PRP among patients with advanced diabetic retinopathy. Data from RCTs with mostly some concerns for bias (RoB 2 tool) and CCTs with mostly moderate risk of bias (ROBINS-I tool) show benefit of using MSL over SSL, and NNL over conventional systems for PRP in diabetic retinopathy, considering pain as the primary outcome.

Keywords: NAVILAS®; PASCAL®; diabetic retinopathy; pain; panretinal photocoagulation.

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Conflict of interest statement

The authors report no conflicts of interest for this work.

Figures

Figure 1
Figure 1
Search yield.
Figure 2
Figure 2
Risk of bias assessment of included RCTs.
Figure 3
Figure 3
Risk of bias assessment of included CCTs.
Figure 4
Figure 4
Forest plot comparing conventional MSL and conventional SSL.
Figure 5
Figure 5
Forest plot comparing NNL and conventional MSL (Pulse duration: 30-ms).
Figure 6
Figure 6
Forest plot comparing long-pulse NNL and conventional SSL (pulse duration: 100-ms).
See this image and copyright information in PMC

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