Laser Photocoagulation - Pan Retinal Photocoagulation(PRP)

How is the laser done for diabetic retinopathy?
Laser is usually done to close the leaking vessels causing macular edema or to close the abnormal blood vessels. Usually the laser treatment is divided in 3-4 parts to minimize side effects. Each sitting is done 3-7 days apart.
 
What are the chances of success? How much vision will I regain?
The aim of the laser treatment is to preserve and maintain the current level of vision. It is usually successful in preventing further visual loss. It is not intended to improve the vision. However, in some cases it may improve vision, but that is not predictable.
 
How long can I wait for the laser?
The laser if required should be done as soon as possible to prevent further damage to retina.
 
How is the laser done?
The laser is usually done by putting eye drops in eye. Only in few cases a local anesthesia with injection is required. It is done sitting on the machine or sometimes lying down. Laser photocoagulation is an outpatient procedure. You will be able to go home afterward.
 
How long will it take?
The laser itself takes around 15 to 20 minutes for each eye.
 
Does it pain during laser?
It usually does not pain during the laser. However, a feeling of discomfort or a pricking sensation can be felt by some. Any pain, if felt, is usually tolerable. In rare cases if pain sensitivity is high, injection can be given to numb the pain.
 
What are the precautions after the laser?
After laser, vision is temporarily reduced for few minutes after which it improves rapidly.However, for about 24 hours after your procedure, your vision may be hazy or blurry.You have to take some tablets and eye drops prescribed by doctors. You will be able to go home afterward, but you will need to arrange for transportation, as you will not be able to drive immediately following surgery. You can carry about your normal routine. But avoid lifting weights or heavy objects,and strenuous exercise.Heavy cough and constipation if present should be treated.
 
What are possible complications / side effects?
Because laser photocoagulation involves tiny burns to seal the capillaries, small spots may appear in your field of vision after the procedure. These small spots generally fade and disappear with time. If your vision was blurry prior to the laser photocoagulation procedure, you may not completely recover clear vision.Usually, you will regain your vision to the pretreatment level.

Sometimes you may get difficulty in seeing in dim light or in night. Your vision may remain depressed for a while but will recover over next 2-3 months.
 
Will this recur again?/ Will I need another laser?
The laser is usually successful in closing abnormal blood vessels in almost 95-97% patients. However, if the sugar levels remain uncontrolled or fluctuating this may recur in some patients. Failure to control blood pressure may also be responsible for recurrence. In this case an additional laser treatment will be required. Sometimes intraocular injections may have to be given.

As the diabetes is a continuous disease, so are its effects on retina. That’s why it is imperative to have routine examinations of retina even after laser. It helps in detecting and treating any adverse events, if any.
 
Is there any treatment without laser?
No. Currently there is no effective treatment for proliferative disease which leads to long term stabilization of vision.
 
Can this be cured with glasses or with lens inside eye?
No. This can not be cured with glasses or medicines. Putting lens inside eye is treatment for cataract and will not stop bleeding or leaking blood vessels in your retina which is the cause of loss of vision in your case. However, if a cataract is present simultaneously, IOL can be put before or after laser depending on the stage of cataract.
 
What will happen if I don’t get laser done?
Failure to treat will lead to growth of these abnormal vessels. These may bleed from time to time. They also can contract and pull the retina away from the back wall of eye leading to tractional detachment. At this stage only a vitrectomy surgery can salvage remaining vision. However, if vitrectomy is not done promptly, usually only an ambulatory vision is regained. After few years the eye will permanently become blind.
 
Will this affect my other eye?
Yes. As diabetes affects all your body, naturally other eye will also be affected. Usually it affects both eyes simultaneously, but frequently it is more advanced in one of the eyes.
 
I have been advised an injection inside eye. How it will be useful?
An injection is advised usually to treat the macular edema, present along with. Either a triamcinolone or Avastin (Bevacizumab) is injected inside the eye. The choice of drug depends on the condition of eye.

Alternately, Avastin (Bevacizumab) is advised to rapidly dry out the abnormal vessels. This is usually required if there are blood vessels growing over iris and blocking the normal channels to drain the fluid inside the eye.
Laser Photocoagulation Diabetic Macular Edema Vitrectomy Surgery