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Short-pulse multi-spot PRP, burn size and the risk of undertreatment

Eye (2026)Cite this article

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To the editor

The editorial by Burgess et al. [1] emphasises the importance of pan-retinal photocoagulation (PRP) in proliferative diabetic retinopathy (PDR) but contains points that need clarification. Clear specification of all parameters for PRP is essential to avoid undertreatment. In ETDRS, “full” PRP was 1200-1600 500 μm diameter burns of 100 ms pulse duration, with 1600 burns equating to 314 mm2 of retina. A widefield non-perfusion study has shown that a non-perfused area of ~300 mm2 will generate proliferation [2].

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Fig. 1: Relative healed diameters of conventional 100-ms PRP burns (~500 µm) versus short-pulse (10–20 ms) burns (~250 µm).

References

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  1. Cwm Taf Morgannwg University Health Board, Llantrisant, Wales, UK

    Kevin Gallagher

  2. St Thomas’ Hospital, London, UK

    Nigel Davies

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  1. Kevin Gallagher
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  2. Nigel Davies
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KG and ND drafted and revised the manuscript and approved the final version.

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Correspondence to Kevin Gallagher.

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Gallagher, K., Davies, N. Short-pulse multi-spot PRP, burn size and the risk of undertreatment. Eye (2026). https://doi.org/10.1038/s41433-026-04248-z

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