Diabetic Retinopathy Treatment

Photocoagulation is such an effective tool for managing diabetic retinopathy that it has become the most common form of treating the disease. During treatment, the laser beam is used to seal leaking blood vessels through thermal coagulation or cauterization. Laser beam spots can also be scattered through the periphery of the retina to reduce abnormal blood vessel growth often seen in diabetic patients, and to help seal the retina to the back of the eye to guard against a retinal detachment. Photocoagulation procedures are usually performed in the ophthalmologist’s office, and little recuperation time is needed.

Age-related Macular Degeneration Treatment

For 15 to 20 percent of people who suffer from the the form of age-related macular degeneration (AMD) that includes the proliferation of new abnormal blood vessels in or near the retina, photocoagulation treatment can successfully seal the leaking blood vessels in the retina and discourage their growth. Even so, the procedure will not restore lost vision, and only slows the progression of the disease.

To treat AMD with laser photocoagulation, the ophthalmologist uses angiogram photos of the patient’s retina to examine the detailed vasculature in the retina to identify unhealthy new vessel growth. The laser is then used to coagulate and seal the unwanted blood vessels. This outpatient procedure is non-invasive, painless and takes approximately 15-20 minutes. Follow-up visits and repeat treatments may be recommended.

Diabetic Macular Oedema Treatment

Diabetes is a vascular disease which can damage the delicate micro-vasculature in the retina –this damage often allows fluid to leak and accumulate in the retina, thereby causing retinal thickening. Laser photocoagulation treatment is usually applied to the areas of maximal retinal thickening/oedema, and is very successful in most cases in reversing, stabilizing or slowing the progression of diabetic macular oedema.

Peripheral Retinal Tear Treatment

The clear fibrous filling in the back of the eye (the vitreous) can become more fluid and the more solid portion of the vitreous may move forward, leaving clear fluid behind it (posterior vitreous detachment). When this occurs, the vitreous may, by chance, remain stuck to one or two areas in the outer part of the retina and as result in traction that pulls the retina forward and out of place. The area of abnormal attachment will often spontaneously release the vitreous, but in some patients it will tear a hole in the retina instead. This hole, if left untreated, will usually lead to a larger hole and a retinal detachment as fluid passed through. Once a retinal detachment due to a tear starts, it usually progresses and leads to a total retinal detachment. Retinal detachments can usually be repaired by surgery but a small number cannot. It is therefore important to detect and treat a retinal tear before there is a detachment or when a detachment is still localized. In these cases, laser photocoagulation is usually very successful. The attached retina around the hole is treated with an intense barrier of laser spots, which permanently seals off the tear and prevents any fluid from passing through and further detaching the retina.

Drug therapy has traditionally been used to lower IOP by increasing aqueous outflow or reducing fluid production. However, there are numerous complications associated with long-term drug use, and many patients find that drug therapy alone does not effectively reduce IOP. Argon Laser Trabeculoplasty (ALT) is a microsurgical procedure that increases aqueous outflow by improving the function of the trabecular meshwork, which is responsible for draining aqueous fluid. By placing small laser burns on the surface of the trabecular meshwork, acoustic effects and the body’s natural immune response to the micro-burns result in improved outflow function. The ALT micro-burns do cause scarring of the trabecular meshwork, therefore eye doctors limit the use of ALT to patients that have failed other non-invasive treatment options.

A less common form of glaucoma occurs when the aqueous fluid flow is obstructed by the anatomy of the eye blocking the path for fluid to reach the trabecular meshwork. This is known as Angle Closure Glaucoma (ACG) and often treated by performing a Laser Iridotomy with a photodisruptor. During iridotomy, a laser is used to create a tiny opening in the peripheral iris that allows fluid to flow directly into the anterior chamber from behind the iris. This typically resolves the built-up IOP and allows the anatomy of the eye to return to its normal state. Laser peripheral iridotomy is usually completed in the physician’s office or as a brief outpatient procedure in a hospital.