Wan Wei, Loo
(2015)
A randomised controlled trial on effects of contact and non-contact laser
photocoagulation therapy on ocular surface in patients with proliferative diabetic retinopathy.
Masters thesis, Universiti Sains Malaysia.
Abstract
Introduction
Ocular surface changes are commonly seen in diabetes mellitus. It can be made worse
by either contact or non-contact laser photocoagulation (LP) in proliferative diabetic
retinopathy (PDR).
Objective
The aim of the study is to evaluate the effects of contact and non-contact LP therapy on
ocular surface changes and Ocular Surface Disease Index (OSDI) score in patients with
PDR.
Methods
This is a randomized controlled trial in Hospital Universiti Sains Malaysia from June
2013 to May 2015. Patient with PDR was selected and randomized into 2 groups by
using random sampling envelope method, Contact LP group and Non-contact LP group.
Patients were evaluated for Schirmer test, tear film break-up time (TBUT) and
assessment of OSDI questionnaire before treatment and 3 months post laser treatment.
Statistical analyses were performed using SPSS version 22.0.
Results
A total of 60 eyes from 34 patients were recruited (Contact LP: 30 eyes from 17 patients
and Non-contact LP: 30 eyes from 17 patients). There was no significant difference in
mean change of the Schirmer test (p=0.378) at 3 months post treatment between the two
groups. Although there was significant reduction in TBUT at 3 months post laser in Contact LP group (p=0.038), but there was no significant difference in mean change of
TBUT between the two groups (p=0.549). There was significant increased in mean
change of OSDI score at 3 months post treatment in Contact LP group as compared to
Non-contact LP group (p=0.044).
Conclusion
Contact LP resulted in significant worsening of TBUT and increasing in OSDI sore.
However, non-contact LP may not minimize the effect of laser on ocular surface of
diabetic retinopathy patients. Appropriate care should be given to the ocular surface of
diabetic retinopathy patients during LP procedure.
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