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Laser photocoagulation - eye

  • Definition
    • Diabetes can harm the eyes. It can damage the small blood vessels in the retina, the back part of your eye. This condition is called diabetic retinopathy.

      Laser photocoagulation is eye surgery using a laser to shrink or destroy abnormal blood vessels in the retina. It is commonly used to treat diabetic retinopathy.

  • Alternative Names
    • Laser coagulation; Laser eye surgery; Photocoagulation; Laser photocoagulation - diabetic eye disease; Laser photocoagulation - diabetic retinopathy; Focal photocoagulation; Scatter (or pan retinal) photocoagulation; Proliferative retinopathy - laser; PRP - laser; Grid pattern photocoagulation - laser

  • Description
    • Your doctor will perform this surgery at an outpatient or office setting.

      Photocoagulation takes place by using the laser to create a microscopic burn in the target tissue. The laser spots are usually applied in 1 of 3 patterns.

      Before the procedure, you will be given eye drops to dilate your pupils. Rarely, you will get a shot of a local anesthetic. The shot may be uncomfortable. You will be awake and pain-free during the procedure.

      You will be seated with your chin in a chin rest. A special contact lens will be placed on your eye. The lens contains mirrors that help the doctor aim the laser. You will be instructed to look straight ahead or at a target light with your other eye.

      A laser will be focused on the bleeding vessels to seal or destroy them. You may see flashes of light during the procedure. There are two types of laser surgery:

      • In focal surgery, the laser is focused on a small section of the retina. The doctor makes small burns to seal the leaking blood vessels.
      • Scatter treatment is used when leaking blood vessels cover a wider area of the retina. The doctor uses the laser to make multiple laser burns. You may need a few treatment sessions to stop the blood vessels from growing.
  • Why the Procedure is Performed
    • Laser surgery helps reduce the risk of blindness in people with diabetic retinopathy. People with early diabetic retinopathy may not need treatment.

      You may need treatment if your eye doctor notices these problems:

      • New blood vessels growing in your retina
      • Blurry vision due to fluid leaking into the area of the retina that provides sharp central vision (macular edema)

      This surgery also treats the following eye problems:

  • Risks
    • Since parts of the retina are burned, you may develop:

      • Mild loss of vision
      • Reduced night vision
      • Blind spots
      • Difficulty focusing
      • Blurred vision
      • Reduced color vision

      If not treated, diabetic retinopathy can cause permanent blindness.

  • Before the Procedure
    • If your blood sugar has been very high, your doctor will give you medicines to lower your blood sugar level.

      Arrange to have someone to drive you home after the procedure.

  • After the Procedure
    • You vision will be blurry for the first 24 hours. You may see floaters, but these will fade away in time. If your treatment was for macular edema, your vision may seem worse for a few days.

  • Outlook (Prognosis)
    • Laser surgery works best in the early stages of vision loss. It cannot bring back lost vision. However, it can greatly reduce the risk of permanent vision loss.

      Managing your diabetes can help prevent diabetic retinopathy. Follow your eye doctor's advice on how to protect your vision. Have eye exams as often as recommended, usually once every 1 to 2 years.

  • References
    • Jaegers KR, Vander JF. History of photocoagulation retinitis pigmentosa and allied retinal diseases. In: Tasman W, Jaeger EA, eds. Duane's Clinical Ophthalmology. 2013 ed. Philadelphia, PA: Lippincott, Williams & Wilkins: 2013:vol 6;chap 76.

      Lim JI, Rosenblatt BJ, and Benson WE. Diabetic retinopathy. In: Yanoff M, Duker JS, eds. Ophthalmology. 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 6.21.

      Mathew C, Yunirakasiwi A, Sanjay S. Updates in the management of diabetic macular edema. J Diabetes Res. 2015;2015:794036. PMID: 25984537