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Laser photocoagulation (for diabetic retinopathy)

Laser photocoagulation is a medical procedure that consists of applying a light beam that in contact with the eye has a thermal effect, resulting in fine cauterization of blood vessels in the eye. Depending on the pathology, this procedure can be performed in the operating room or in the doctor’s office.

What you need to know about laser photocoagulation for diabetic retinopathy?

Laser photocoagulation uses the heat from a laser to seal or destroy abnormal blood vessels that leak into the retina. Laser photocoagulation is a medical procedure that involves applying a beam of light that, when in contact with the eye, has a thermal effect, resulting in the fine cauterization of blood vessels at the eye level. Depending on the pathology, this procedure can be performed in the operating room or in the doctor’s practice. Patient preparation is done by instilling anesthetic and dilating drops. The patient sits in a chair while the doctor applies an examination lens. Through the microscope, a magnified image of the retina is visualized.

 When treating diabetic retinopathy, one of two approaches may be used:

  • Focal photocoagulation

Focal treatment is used to seal blood vessels leaking in a small area of the retina, usually near the macula. The ophthalmologist identifies individual blood vessels for treatment and performs a limited number of laser cauterizations to seal them.

  • Pan-retinal photocoagulation

Pan-retinal treatment is used to slow the growth of abnormal new blood vessels that have developed over a larger area of the retina. The ophthalmologist can perform hundreds of laser cauterizations on the retina to stop the growth of blood vessels. The person may need two or more treatment sessions.

Laser photocoagulation is usually not painful. You may feel a slight stinging sensation or see brief flashes of light when the laser is applied to the eye.

What to expect after treatment?

Laser photocoagulation is usually performed as an outpatient procedure using a local anesthetic that affects only the eye.

You will need someone to drive you home from the medical practice or clinic after the procedure. Eye drops are used to dilate your pupils before the procedure. Your eyes will remain dilated for a few hours afterwards. Wear sunglasses to protect yourself from bright light while your pupils are still dilated.

Your vision may be blurry, and the eye may experience discomfort for a day or two after treatment.

Make sure to have a follow-up examination after treatment and report to your ophthalmologist any changes in vision that you notice. Regular check-ups can make a significant difference in maintaining long-term vision.

When is laser photocoagulation indicated?

Laser photocoagulation is performed to reduce the risk of vision loss caused by diabetic retinopathy. It is most often used to stabilize vision and prevent potential vision loss, rather than to improve vision loss that has already occurred. (Sometimes, focal photocoagulation for macular edema caused by non-proliferative retinopathy can help restore lost vision.)

Laser photocoagulation can be used to treat and prevent the progression of:

Macular edema – focal photocoagulation is sometimes used in these cases.

Proliferative retinopathy – scattered (pan-retinal) photocoagulation is used to treat proliferative retinopathy.

It is possible that laser treatment will not restore vision that has already been lost. But when done in a timely manner, laser treatment can reduce the risk of vision loss in the future.

Laser photocoagulation is indicated in multiple conditions such as diabetic retinopathy, retinal vascular occlusions, some retinal vascular conditions, ocular tumors, retinal detachment. Depending on the condition being treated, the number of sessions may vary. In diabetic retinopathy, treatment begins with 3 sessions at an interval of 2 weeks.

Risks

Laser photocoagulation burns and destroys part of the retina and may lead to permanent loss of vision. The treatment may cause slight loss of central vision, reduced night vision, and decreased concentration. Some people may lose part of their peripheral (side) vision. However, the vision loss caused by laser treatment is mild compared to the vision loss that can be caused by untreated retinopathy.

The rare complications of laser photocoagulation include:

Bleeding in the eye (vitreous hemorrhage).

Retinal detachment.

Accidental laser burn of the fovea (a depression in the central macula that does not contain blood vessels). This results in severe loss of central vision.

However, the immediate loss of vision caused by laser treatment must be measured against the more severe loss of vision that could result from untreated retinopathy. For individuals with diabetic retinopathy, laser photocoagulation will very likely help prevent more severe loss of vision over time.

Diabetes experts agree that early detection and treatment of retinopathy can prevent many, if not most, cases of severe loss of vision and blindness in individuals suffering from diabetes.

Make sure to keep your blood sugar levels low after laser treatment. Even if your eyes see better, diabetic retinopathy will continue to worsen over time if blood sugar levels rise again.

At Dr. Holhoș clinics, laser procedures are performed using Zeiss equipment, state-of-the-art devices with a high level of performance.

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Important note regarding patient consultations and surgery appointments

A patient who cancels a consultation or surgery appointment once, at least one day prior to the scheduled appointment, has the right to a second appointment under the same conditions.
If the patient cancels the second consultation and/or surgery appointment, a new appointment can be made only if the patient accepts to pay for both the consultation and the surgery in advance. This can be done either by payment order or in cash at the clinic reception.
A patient who does not show up for their consultation or surgery, who does not cancel the appointment in due time, or does not answer the clinic’s calls, may request a second appointment only if they pay for the consultation/surgery in advance. 
Patients requesting an appointment for retinal surgeries or laser Prk/Femtolasik/Smile Pro must pay 30% of the cost of the surgery in advance. The appointment will be scheduled only after receiving the advance payment. If the patient is unable to attend the scheduled consultation or surgery, and cancels the intervention at least 48 hours beforehand, they will be refunded in full. If the patient does not show up and does not cancel or contact the clinic at least 48 hours in advance, the advance paid is considered to be lost as damages and will no longer be refunded.