Reduction of Fluence to Decrease Pain During Panretinal Photocoagulation in Diabetic Patients

Background and Objective: To assess the effect of laser fluence reduction to reduce pain during panretinal photocoagulation. Patients and Methods: Twenty-five patients (50 eyes) with diabetic retinopathy who had indication for panretinal photocoagulation were included in this prospective, interventional, and comparative study. The right eyes were treated using low fluence parameters (LFP), whereas the left eyes were treated with standard fluence parameters (SFP). At the end of each session, the patient was asked to rate pain from 0 (no pain) to 10 (maximum pain) for each eye (NRS-11 scale). Fluence per burn and total fluence were determined for each eye. Statistical analysis was performed using the Mann–Whitney U test and the Pearson correlation coefficient. Results: Pain perception ( P < .01) and fluence per burn ( P < .01) were significantly less using LFP compared with SFP. Pain was proportional to fluence per burn (R 2 = 0.4), but not to number of burns (R 2 = −0.2). Conclusion: The use of LFP seems to be a good option to diminish the pain during panretinal photocoagulation.