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 vision.
The retina is the layer of cells in the back of your eye that converts light into electrical signals. Your retina then sends these signals to your brain. AMD affects your macula. The macula is the sensitive, central part of your retina. This area is responsible for the detailed vision in the middle of your visual field. AMD damages your macula. Blood vessels may grow beneath your macula, causing blood and fluid to leak beneath it. This excess blood and fluid can lead to vision loss.
Before the surgery, you are given an anesthetic eye drop. An eye doctor then uses an intense beam of light to burn small areas of the macula. This seals off the leaky blood vessels. This can help prevent more vision loss.
Laser photocoagulation is one type of treatment for AMD. AMD is a common cause of severe vision 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.
AMD has two types: dry type and wet type. Abnormal blood vessel growth is present in only the wet type. Laser photocoagulation is advised only for the wet type of the disease. Laser photocoagulation is only an option for certain people with wet type AMD. Your eye doctor might advise the procedure if your abnormal blood vessels cluster tightly together. The procedure is less helpful if you have scattered vessels. It is also less helpful if they are in the central area of the macula. Your doctor may be more likely to advise the procedure if your vision loss comes on suddenly instead of slowly.
Laser photocoagulation doesn’t always restore vision that you already have lost. However, it may slow down the damage to your central vision.
Other treatment options for AMD include drugs that decrease abnormal blood vessel growth. Your doctor may advise the use of drugs and laser photocoagulation. Talk with your healthcare provider about the risks and benefits of all your treatment options.
During laser photocoagulation, the eye doctor burns away part of the macula. This often results in some additional vision loss. You might have a blind spot where the laser creates a scar. In some cases, this vision loss might be worse than the potential vision loss from not treating the eye. This is something to think about when planning to have the surgery.
The procedure has some other possible risks as well. These include:
- Accidental treatment of the central macula, which causes a worse blind spot
- Bleeding into the eye
- Damage to the retina from the laser scar, immediately or years later
There is also a risk that the abnormal blood vessels might grow back. If this happens, you might need to repeat the treatment.
Your risks may differ based on your age, general health, and the type of AMD you have. Ask your eye doctor which risks apply most to you.
Ask your eye doctor what you need to do to prepare for laser photocoagulation. Ask your eye doctor if you need to stop taking any medicines before the procedure.
Your eye doctor may want to use special instruments to shine a light in your eye and examine the back of your eye. You will need to have your eyes dilated for this eye exam. Your eye doctor might order other special tests to get even more information about your eye.
Before the procedure, eye drops will be used to dilate your pupil. It will stay dilated for several hours after the procedure.
It is most often done as an outpatient procedure in an eye doctor’s office or eye clinic. During a typical procedure:
- You may receive a medicine to help you relax. The eye doctor will use anesthetic eye drops and injections to make sure you don’t feel anything.
- Someone will put a special type of contact lens into the affected eye, after you have had numbing drops placed on the eye. This lens helps focus a beam of laser light on the retina using something called a slit lamp.
- The doctor uses the laser to seal off the abnormal blood vessels beneath the macula.
- Your eye may be covered temporarily.
Ask your eye doctor about what you should expect after your surgery. You should be able to go home the same day. Plan to have someone go home with you after the procedure.
Be sure to follow your eye doctor’s instructions about eye care and medicine. Your eye may be a little sore after the procedure, but you should be able to take over-the-counter pain medicines. You may need to wear an eyepatch or dark glasses for a day or so. Ask your healthcare provider whether you should avoid any specific activities as you recover.
You will need close follow-up care with your eye doctor. He or she will monitor you for complications and continue to manage your treatment for AMD. Be sure to tell your eye doctor right away if you have decreased vision or increased eye redness, swelling, or pain.
Your vision may be blurry for a short while after the surgery. Remember that the surgery does often cause an area of new vision loss. But in the long term it may help prevent your vision from getting worse.
Before you agree to the test or the procedure make sure you know:
- The name of the test or procedure
- The reason you are having the test or procedure
- What results to expect and what they mean
- The risks and benefits of the test or procedure
- What the possible side effects or complications are
- When and where you are to have the test or procedure
- Who will do the test or procedure and what that person’s qualifications are
- What would happen if you did not have the test or procedure
- Any alternative tests or procedures to think about
- When and how will you get the results
- Who to call after the test or procedure if you have questions or problems
- How much will you have to pay for the test or procedure
January 16, 2018
Haupert, Christopher L., MD,Walton-Ziegler, Olivia, MS, PA-C