Azarcon CP, Artiaga JCM. Comparison of Pain Scores Among Patients Undergoing Conventional and Novel Panretinal Photocoagulation for Diabetic Retinopathy: A Systematic Review.
Clin Ophthalmol 2021;
15:953-971. [PMID:
33688163 PMCID:
PMC7936685 DOI:
10.2147/opth.s294227]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 01/11/2021] [Indexed: 12/15/2022] Open
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.
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