Dr. Paul Runge + LION = The Gift of Sight

Dr. Paul Runge Brings Advanced Technology to Ukraine for Treating Retinopathy of Prematurity (ROP)

This World Sight Day, Norlase is proud to recognize and highlight the sight-saving work of Dr. Paul Runge. Over multiple trips to the Ukraine, Dr. Runge has treated premature infants at risk of blindness from Retinopathy of Prematurity (ROP). Norlase LION has empowered much of his work.

While in the Ukraine, Dr. Runge conducted a study comparing Red vs Green Laser for ROP. He presented a poster at the 4th Annual Advances in Pediatric Retina (APR) Course in Santa Clara, CA. Read on for study details and findings.

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Advantages of Green Laser for Retinopathy of Prematurity (ROP) in the Ukraine

Key Takeaway

A recent study comparing treatment results for threshold ROP found that green laser, delivered via the Norlase LION laser indirect ophthalmoscope (LIO), was more time- and energy-efficient while treating premature infants in wartime Ukraine.

LION 520 nm green laser required 50% less energy and 25% less time to place 30% more treatment spots compared to 810 nm red laser, leading to a “marked improvement” in ocular conditions and subsequent treatment outcomes.

Study Details

The study was conducted by T. Gavrylyshyn, MD, A. Stefanyshyn, MD, and P. Runge MD at the Regional Children’s Clinical Hospital in Ivano-Frankivs’ka, Ukraine. Between January 2021 March 2023, 32 babies were treated with a red laser and 6 with LION LIO green laser. Analysis compared the treatment and outcome of the 6 most recent babies treated with red laser, and the 6 most recent babies treated with green laser.

All treatment was bilateral, under general anesthesia and performed in the operating room. The Volk 28D lens was used for exams and treatment.

• The initial settings for both the red and green lasers were 150-180 mw power with 150-200 ms duration and 200 ms intervals.
• Both settings were adjusted as necessary to achieve a soft burn.
• On average, 2000 spots were required to cover the avascular retinae.

Benefits of Green vs. Red Laser

The goal of laser treatment for ROP is to treat the peripheral avascular retina as completely and efficiently as possible. This is important because a shorter duration of treatment is better for both the baby and for the treating physician.

In this study, within the selected patient subset, treatment observations included:

Visualization was a crucial factor giving the LION LIO green laser device a distinct advantage. Compared to the red laser setup, LION LIO provided clear visualization of the retina throughout the duration of treatment. Red laser devices can cause a deterioration of the view secondary to corneal edema, even when preservative-free artificial tears, balanced salt solutions, hypertonic saline eye drops, and topical dexamethasone eye drops are employed during treatment.

All these factors lead to a more complete laser treatment and ultimately a better anatomical outcome with the green laser.