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.
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
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:
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:
This surgery also treats the following eye problems:
Since parts of the retina are burned, you may develop:
If not treated, diabetic retinopathy can cause permanent blindness.
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.
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.
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.
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 www.ncbi.nlm.nih.gov/pubmed/25984537.