Pattern scanning laser (PASCAL) technology is a relatively recent development in photocoagulation. This system can fire precise laser patterns into a patient’s eye to help seal tissue as part of treating a variety of retinal diseases.

What Is PASCAL?

The PASCAL photocoagulator is a laser device used by retina surgeons, first developed by OptiMedica.

PASCAL stands for PAtterned SCAnning Laser. It is a device that uses patterned bursts of laser in an automated scanning fashion to help fuse tissue closed.

Uses of PASCAL

The primary purpose of a PASCAL photocoagulator is retina photocoagulation. In other words, it is used to stop bleeding caused by retinal conditions. It represents an alternative to conventional lasers, as it is able to more rapidly shoot lasers in faster bursts.

PASCAL can be effective in the treatment of a variety of retinal diseases, including these:

  • Diabetic retinopathy
  • Retinal vascular occlusion disease
  • Age-related macular degeneration

How It Is Performed

PASCAL photocoagulation is a fairly simple process. It often takes less than 10 minutes, and you likely won’t need an anesthetic.

Once it’s time for your procedure, your doctor will secure your face to the machine, which is designed to minimize neck and back strain, helping you remain comfortable as the doctor and machine work.

The doctor will look at your eye via a device called a slit lamp, often integrated into the laser machine, and then work to set the laser as appropriate. It will then fire precise, controlled bursts into your eye, helping to seal any separated tissue in your eye that may be leaking fluids and causing you problems.

The American Academy of Ophthalmology has created a free simulator to demonstrate how these machines operate. The panel and imaging shown are more or less what a doctor will see, although many aspects of the tool will be difficult to understand for non-experts.

Postoperative Care

One of the advantages of PASCAL photocoagulation is that the rapid bursts of the laser cause heat to defuse less harshly. This helps to minimize pain and simplifies the healing process. However, your doctor will still likely want to schedule some follow-up sessions to monitor your healing and any changes to your vision.

Even if you don’t notice any issues, it is important to go to these sessions because your doctor may be able to notice issues before you can. Thus, they can treat them before they cause significant discomfort or further complications.

Many doctors will prescribe antibiotic and anti-inflammatory drops for the first week after laser eye surgery. This is a precaution meant to reduce your risk of infection and swelling during the earliest parts of the healing process. Follow your doctor’s instructions closely to promote full and rapid recovery.

Benefits of PASCAL

PASCAL photocoagulation is easier for both the patient and doctor compared to conventional laser technology. The machine has an ergonomic design, so both parties can remain comfortable during the procedure. It can fire precise, complex laser patterns very quickly, and it seems to cause less scarring and pain.

Many patients find laser eye surgery intimidating, and PASCAL technology can make it easier for a patient to get the care they need. It is safe and effective, although more studies examining its potential for certain complications (discussed below) are needed. Regardless, nothing suggests that the risk of any complications makes these machines significantly more dangerous than conventional treatments.

Recent Studies on PASCAL

A 2010 study suggested pattern scan laser photocoagulation is safe, with the potential for complications and adverse effects aligning with previous studies. A 2012 study of a small pool (20) of patients showed no tendency for scars to gradually enlarge between initial coagulation and follow-up examinations.

However, a 2017 review of pattern scanning lasers noted that some studies have suggested these systems may have a higher rate of persistent retinal neovascularization compared to the conventional approach.

References

Our Experience With the PASCAL Laser. (February 2010). Retina Today.

PASCAL (PAttern SCAnning Laser) Photocoagulator: Evolution of Size in Photocoagulation Scars. (March 2012). Investigative Ophthalmology & Visual Science.

PASCAL Simulator. (August 2014). American Academy of Ophthalmology.

Pattern Scanning Laser Panretinal Photocoagulation in Proliferative Diabetic Retinopathy. (October 2016). American Academy of Ophthalmology.

Pattern Scan Laser Photocoagulation: Safety and Complications, Experience After 1301 Consecutive Cases. (June 2010). British Journal of Ophthalmology.

PASCAL Laser Platform Produces Less Pain Responses Compared to Conventional Laser System During the Panretinal Photocoagulation: A Randomized Clinical Trial. (December 2018). African Health Sciences.

Initial Experience With the Pascal Photocoagulator: A Pilot Study of 75 Procedures. (June 2008). British Journal of Ophthalmology.

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