Does Wavelength Matter When Photocoagulating Eyes With Macular Degeneration or Diabetic Retinopathy?-Reply

In reply The preliminary work by Brancato and colleagues on the clinical efficacy of diode laser panretinal photocoagulation in eyes with proliferative diabetic retinopathy is duly noted. Unfortunately, the sample size required to evaluate a treatment difference between panretinal photocoagulation performed with argon green vs diode laser is far greater than that which appears in published reports. Thus, it is not yet possible to conclude that the two laser wavelengths provide comparable treatment benefits with equivalent risks. In fact, the work of Brancato and colleagues suggests that diode laser panretinal photocoagulation produces greater patient discomfort, requires more laser sessions to place the treatment, precipitates choroidal detachments, and produces more confluent chorioretinal atrophy than is customarily encountered with argon panretinal photocoagulation. Certainly, a larger-scale and longer-term study is needed to reliably evaluate these issues.