Understanding Laser Photocoagulation for Age-Related Macular Degeneration (AMD)
Laser photocoagulation is a type of laser surgery for the eyes. It is done to treat age-related macular degeneration (AMD). AMD is a condition that can lead to loss of eyesight. Laser photocoagulation uses a laser to seal off abnormal blood vessels in your eye. Laser photocoagulation can’t restore eyesight that you have already lost. But it may slow down the damage to your central vision.
What is AMD?
The retina is a very thin layer of cells in the back of your eye. It converts light into electrical signals and then sends these signals to your brain. The macula is the sensitive center part of your retina. This area gives you detailed vision in the middle of your visual field. AMD damages your macula. The macula may become thinner and deposits of material can develop behind it. Blood vessels may start growing beneath your macula. This can cause fluid to leak beneath your macula. This excess fluid can lead to eyesight loss.
AMD has 2 types: dry and wet. Abnormal blood vessel growth is present in only the wet type. AMD is a common cause of severe eyesight loss in older adults. In rare cases it can result in total blindness. Because AMD affects the macula, you may still have your side (peripheral) vision. But you may have a gradual or sudden loss of central vision.
Why laser photocoagulation for AMD is done
Laser photocoagulation is one type of treatment for AMD. It is a choice only for certain people with wet AMD. Your doctor may advise the surgery if your abnormal blood vessels are close together. The surgery is less helpful if you have scattered vessels. It is also less helpful if they are in the center of the macula. Your doctor may be more likely to advise the surgery if your eyesight loss happens suddenly instead of slowly.
AMD can also be treated with medicine that is injected into the eye and slows down the growth of abnormal blood vessels. Your healthcare provider may use both laser photocoagulation and injected medicine to treat your AMD.
How laser photocoagulation for AMD is done
The eye doctor will use eye drops to enlarge (dilate) your pupil. Your pupil will stay dilated for several hours after the surgery. The doctor will put a special type of contact lens into the affected eye. This lens helps focus a beam of laser light on the retina using a tool called a slit lamp. The doctor uses the laser to seal off the abnormal blood vessels beneath the macula.
Risks of laser photocoagulation
During laser photocoagulation, the doctor burns away part of the macula. This often results in some additional eyesight loss. You might have a blind spot where the laser creates a scar. In some cases, this eyesight loss might be worse than the eyesight loss from not treating the eye. This is something to talk with your doctor about when considering the surgery.
The surgery has some other risks, such as:
Accidental treatment of the central macula, which causes a worse blind spot
Bleeding into the eye
Damage to the retina from the laser scar, right away or years later
Abnormal blood vessels growing back
Need for repeat treatment
Your risks may differ according to your age, your general health, and the type of your AMD. Ask your healthcare provider which risks apply most to you.
March 16, 2019
Age-related macular degeneration: Treatment and prevention. UpToDate.
Chris Haupert MD