The role of laser wavelength in the treatment of vitreoretinal diseases

Advances in laser technology have provided ophthalmologists with lasers spanning the visible and near-infrared spectrum. Recently, prospective, randomized clinical trails have compared laser wave-lengths in the treatment of specific disorders. The Krypton Argon Regression Neovascularization Study found no difference between argon blue-green and krypton red laser when performing panretinal photocoagulation to manage proliferative diabetic retinopathy. The Macular Photocoagulation Study Group and the Canadian Ophthalmology Study Group have independently found no substantial difference in treatment outcome when using argon green versus krypton red laser to treat choroidal neovascularization in eyes with age-related macular degeneration. These recent trials and others that evaluate laser management of proliferative diabetic retinopathy, choroidal neovascularization, retinopathy, of prematurity, and retinal breaks are reviewed. Multiple studies have failed to identify a moderate difference in treatment outcome between treatments performed with different laser wavelengths; however, small differences in outcome cannot be excluded without further study involving great numbers of patients. At the present time, ophthalmologists should be reassured that individual preferences for one wavelength over another in specific situations should not have a major effect on the visual outcome of the procedure.