Ian L McAllister1, Lynne A Smithies, Victor Previn. 1. *Centre for Ophthalmology and Visual Science, Lions Eye Institute, The University of Western Australia, Perth, Australia; and †Ellex Medical Lasers, Adelaide, Australia.
Abstract
PURPOSE: To evaluate the success rate of laser chorioretinal anastomosis (L-CRA) creation with a new laser photocoagulator system capable of 5 watts (W) power in patients with central retinal vein occlusion (CRVO). METHODS: Patients with a treatment-naive CRVO were enrolled as part of an ongoing trial combining L-CRAs with anti-vascular endothelial growth factor treatment. RESULTS: Thirty-three patients were treated with an L-CRA developing in 29 (88%). Mean power was 2.7 W and mean time for development was 1.8 months. Each patient had two potential sites created. Eighteen patients developed 2 L-CRAs and the remaining 11 patients, one each. Of the 66 potential sites, successful L-CRAs developed at 47 sites (71%). Additional Nd:YAG laser applications were used in 39% of sites. Mean follow-up was 23 months and no significant complications were seen. CONCLUSION: An L-CRA as a means of permanently bypassing the obstruction to venous outflow in CRVO may become more relevant as not all patients respond well to intravitreal therapy. The limitation to this technique in the past has been lack of availability of a laser system with the power necessary to create the L-CRA. The success rate with the new system has improved to 88% representing a significant improvement over our original success rate of 33%.
PURPOSE: To evaluate the success rate of laser chorioretinal anastomosis (L-CRA) creation with a new laser photocoagulator system capable of 5 watts (W) power in patients with central retinal vein occlusion (CRVO). METHODS:Patients with a treatment-naive CRVO were enrolled as part of an ongoing trial combining L-CRAs with anti-vascular endothelial growth factor treatment. RESULTS: Thirty-three patients were treated with an L-CRA developing in 29 (88%). Mean power was 2.7 W and mean time for development was 1.8 months. Each patient had two potential sites created. Eighteen patients developed 2 L-CRAs and the remaining 11 patients, one each. Of the 66 potential sites, successful L-CRAs developed at 47 sites (71%). Additional Nd:YAG laser applications were used in 39% of sites. Mean follow-up was 23 months and no significant complications were seen. CONCLUSION: An L-CRA as a means of permanently bypassing the obstruction to venous outflow in CRVO may become more relevant as not all patients respond well to intravitreal therapy. The limitation to this technique in the past has been lack of availability of a laser system with the power necessary to create the L-CRA. The success rate with the new system has improved to 88% representing a significant improvement over our original success rate of 33%.
Authors: Ian L McAllister; Lynne A Smithies; Fred K Chen; David A Mackey; Paul G Sanfilippo Journal: JAMA Ophthalmol Date: 2018-12-01 Impact factor: 7.389