Cochrane · systematic review · CD012314
Different lasers and techniques for proliferative diabetic retinopathy
Moutray, T, Evans, JR, Lois, N, et al. · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library
Eyes and VisionAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
54
current version
GRADE rated
27
No studies
27
Included studies
NR
No studies 27 · 50%Ungraded 0 · 0%Very low 16 · 29.6%Low 10 · 18.5%Moderate 1 · 1.9%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Nd:YAG laser compared to argon‐green laser for proliferative diabetic retinopathy
Population: people with proliferative diabetic retinopathy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
BCVA: loss of 15 or more ETDRS letters Nd:YAG laser vs argon‐green laser | RR 0.8 [0.3, 2.13] | 1 study · 20 participants | Very low Downgraded: risk of bias |
BCVA: gain of 15 or more ETDRS letters Nd:YAG laser vs argon‐green laser | RR 0.33 [0.02, 7.32] | 1 study · 20 participants | Very low Downgraded: risk of bias |
Progression of PDR Nd:YAG laser vs argon‐green laser | RR 1 [0.07, 14.95] | 1 study · 42 participants | Very low Downgraded: risk of bias |
Regression of PDR Nd:YAG laser vs argon‐green laser | RR 1 [0.87, 1.14] | 1 study · 42 participants | Very low Downgraded: risk of bias |
Pain during laser treatment Nd:YAG laser vs argon‐green laser | RR 1 [0.36, 2.76] | 2 studies · 62 participants | Very low Downgraded: risk of bias |
Vision‐related QoL ‐ not reported Nd:YAG laser vs argon‐green laser | no estimate extracted | NR | No studies |
Adverse events Nd:YAG laser vs argon‐green laser | RR 1.22 [0.38, 3.94] | 2 studies · 62 participants | Very low Downgraded: risk of bias |
Diode laser compared to argon laser for proliferative diabetic retinopathy
Population: people with proliferative diabetic retinopathy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
BCVA: loss of 15 or more ETDRS letters Diode laser vs argon laser | RR 0.95 [0.66, 1.36] | 2 studies · 134 participants | Very low Downgraded: risk of bias |
BCVA: gain of 15 or more ETDRS letters Diode laser vs argon laser | RR 0.6 [0.25, 1.45] | 2 studies · 134 participants | Very low Downgraded: risk of bias |
Progression of PDR Diode laser vs argon laser | RR 0.9 [0.41, 2] | 1 study · 66 participants | Very low Downgraded: risk of bias |
Regression of PDR Diode laser vs argon laser | RR 0.75 [0.35, 1.6] | 1 study · 66 participants | Very low Downgraded: risk of bias |
Pain during laser treatment Diode laser vs argon laser | RR 3.07 [2.15, 4.39] | 4 studies · 228 participants | Moderate Downgraded: risk of bias |
Vision‐related QoL ‐ not reported Diode laser vs argon laser | no estimate extracted | NR | No studies |
Adverse events Diode laser vs argon laser | RR 0.5 [0.05, 4.86] | 2 studies · 134 participants | Very low Downgraded: risk of bias |
0.5 compared to 0.1 second exposure for proliferative diabetic retinopathy
Population: proliferative diabetic retinopathy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
BCVA: loss of 15 or more EDTRS letters ‐ 1 year 0.5 vs 0.1 second exposure | RR 0.42 | 1 study · 44 participants | Low Downgraded: risk of bias |
BCVA: gain of 15 or more EDTRS letters ‐ 1 year 0.5 vs 0.1 second exposure | RR 2.22 [0.68, 7.28] | 1 study · 44 participants | Low Downgraded: risk of bias |
Progression of PDR ‐ 1 year 0.5 vs 0.1 second exposure | RR 0.33 [0.02, 7.14] | 1 study · 16 participants | Very low Downgraded: risk of bias |
Regression of PDR ‐ 1 year 0.5 vs 0.1 second exposure | RR 1.17 [0.92, 1.48] | 1 study · 32 participants | Low Downgraded: risk of bias |
Pain during laser treatment ‐ not reported 0.5 vs 0.1 second exposure | no estimate extracted | NR | No studies |
Adverse events 0.5 vs 0.1 second exposure | no estimate extracted | 1 study · 44 participants | Very low Downgraded: risk of bias |
Light PRP compared to classic PRP for proliferative diabetic retinopathy
Population: proliferative diabetic retinopathy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
BCVA: loss of 15 letters or more ‐ not reported Light PRP vs classic PRP | no estimate extracted | NR | No studies |
BCVA: gain of 15 letters or more ‐ not reported Light PRP vs classic PRP | no estimate extracted | NR | No studies |
Progression of DR ‐ not reported Light PRP vs classic PRP | no estimate extracted | NR | No studies |
Regression of PDR ‐ not reported Light PRP vs classic PRP | no estimate extracted | NR | No studies |
Pain during laser treatment Light PRP vs classic PRP | RR 0.23 [0.03, 1.93] | 1 study · 65 participants | Low Downgraded: imprecision |
Adverse events Light PRP vs classic PRP | no estimate extracted | 1 study · 65 participants | Very low Downgraded: imprecision |
Mild scatter PRP compared to full scatter PRP for proliferative diabetic retinopathy
Population: proliferative diabetic retinopathy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
BCVA: loss of 15 or more ETDRS letters ‐ not reported Mild scatter PRP vs full scatter PRP | no estimate extracted | NR | No studies |
BCVA: gain of 15 or more ETDRS letters ‐ not reported Mild scatter PRP vs full scatter PRP | no estimate extracted | NR | No studies |
Progression if PDR ‐ not reported Mild scatter PRP vs full scatter PRP | no estimate extracted | NR | No studies |
Regression of PDR ‐ not reported Mild scatter PRP vs full scatter PRP | no estimate extracted | NR | No studies |
Pain during laser treatment ‐ not reported Mild scatter PRP vs full scatter PRP | no estimate extracted | NR | No studies |
Vision‐related QoL ‐ not reported Mild scatter PRP vs full scatter PRP | no estimate extracted | NR | No studies |
Adverse events ‐ not reported Mild scatter PRP vs full scatter PRP | no estimate extracted | NR | No studies |
Central PRP compared to peripheral PRP for proliferative diabetic retinopathy
Population: proliferative diabetic retinopathy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
BCVA: loss of 15 or more ETDRS letters ‐ 1 year Central PRP vs peripheral PRP | RR 3 [0.67, 13.46] | 1 study · 50 participants | Low Downgraded: risk of bias |
BCVA: gain of 15 or more ETDRS letters ‐ 1 year Central PRP vs peripheral PRP | RR 0.25 [0.03, 2.08] | 1 study · 50 participants | Low Downgraded: risk of bias |
Progression of DR ‐ not reported Central PRP vs peripheral PRP | no estimate extracted | NR | No studies |
Regression of PDR ‐ not reported Central PRP vs peripheral PRP | no estimate extracted | NR | No studies |
Pain during laser treatment ‐ not reported Central PRP vs peripheral PRP | no estimate extracted | NR | No studies |
Vision‐related QoL ‐ not reported Central PRP vs peripheral PRP | no estimate extracted | NR | No studies |
Adverse events Central PRP vs peripheral PRP | no estimate extracted | 1 study · 50 participants | Very low Downgraded: risk of bias |
Centre sparing PRP compared to full scatter PRP for proliferative diabetic retinopathy
Population: proliferative diabetic retinopathy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
BCVA: loss of 15 or more ETDRS letters Centre sparing PRP vs full scatter PRP | RR 0.67 [0.3, 1.5] | 1 study · 53 participants | Low Downgraded: risk of bias |
BCVA: gain of 15 or more ETDRS letters Centre sparing PRP vs full scatter PRP | no estimate extracted | NR | No studies |
Progression of DR ‐ not reported Centre sparing PRP vs full scatter PRP | no estimate extracted | NR | No studies |
Regression of PDR Centre sparing PRP vs full scatter PRP | RR 0.96 [0.73, 1.27] | 1 study · 53 participants | Low Downgraded: risk of bias |
Pain during laser treatment ‐ not reported Centre sparing PRP vs full scatter PRP | no estimate extracted | NR | No studies |
Vision‐related QoL ‐ not reported Centre sparing PRP vs full scatter PRP | no estimate extracted | NR | No studies |
Adverse events ‐ not reported Centre sparing PRP vs full scatter PRP | no estimate extracted | NR | No studies |
Extended targeted PRP compared to standard PRP
Population: people with diabetic retinopathy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
BCVA: loss of 15 or more ETDRS letters: Extended targeted PRP vs standard PRP | RR 0.94 [0.7, 1.28] | 1 study · 270 participants | Low Downgraded: risk of bias |
BCVA: gain of 15 or more ETDRS letters: Extended targeted PRP vs standard PRP | no estimate extracted | NR | No studies |
Progression of DR ‐ not reported Extended targeted PRP vs standard PRP | no estimate extracted | NR | No studies |
Regression of PDR Extended targeted PRP vs standard PRP | RR 1.11 [0.95, 1.31] | 1 study · 270 participants | Low Downgraded: risk of bias |
Pain during laser treatment ‐ not reported Extended targeted PRP vs standard PRP | no estimate extracted | NR | No studies |
Vision‐related QoL ‐ not reported Extended targeted PRP vs standard PRP | no estimate extracted | NR | No studies |
Adverse events Extended targeted PRP vs standard PRP | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision |