Micropulse laser for managing DME
Despite the evidence demonstrating its efficacy and safety, subthreshold micropulse laser has faced several obstacles to adoption.


Cheryl Guttman Krader
Published: Monday, March 13, 2017

Retina specialists who perform subthreshold micropulse laser treatment may feel as if they are performing ‘retinal homeopathy'IMPEDIMENTS TO GREATER USE Dr. Gerardo suggested that despite the evidence demonstrating its efficacy and safety, subthreshold micropulse laser has faced several obstacles to adoption. First, laser in general is considered less effective than anti-VEGF therapy, and subthreshold micropulse laser treatment is a latecomer to the treatment armamentarium compared with anti-VEGF injections. In addition, the fact that the subthreshold micropulse modality does not produce visible lesions may create skepticism about whether the treatment is really doing anything. “Retina specialists who perform subthreshold micropulse laser treatment may feel as if they are performing ‘retinal homeopathy’,” Dr. Garcia said. Although we do not have a lot of tools to prove it, findings from imaging with scanning laser opthalmoscopy and spectral domain optical coherence tomography provide evidence that subthreshold micropulse laser does cause a biologic effect. (AM J Opthalmolol 2010:150:856-862) The absence of visible lesions with subthreshold micropulse laser treatment also made it difficult to track treated areas using lasers delivering single spots. This issue, however, has been addressed by the introduction of pattern laser delivery systems that provide better spot coverage without overlap while also increasing treatment efficiency.
Latest Articles
Beyond the Numbers
Empowering patient participation fosters continuous innovation in cataract surgery.
Thinking Beyond the Surgery Room
Practice management workshop focuses on financial operations and AI business applications.
Aid Cuts Threaten Global Eye Care Progress
USAID closure leads retreat in development assistance.
Supplement: ESCRS Clinical Trends Series: Presbyopia
Nutrition and the Eye: A Recipe for Success
A look at the evidence for tasty ways of lowering risks and improving ocular health.
New Award to Encourage Research into Sustainable Practices
Sharing a Vision for the Future
ESCRS leaders update Trieste conference on ESCRS initiatives.
Extending Depth of Satisfaction
The ESCRS Eye Journal Club discuss a new study reviewing the causes and management of dissatisfaction after implantation of an EDOF IOL.
Conventional Versus Laser-Assisted Cataract Surgery
Evidence favours conventional technique in most cases.
AI Scribing and Telephone Management
Automating note-taking and call centres could boost practice efficiency.