ProceduresRetinal Laser Surgery

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Last updated 10/8/2019
Retinal Laser Surgery, Assil Eye Institute

CAN LASERS BE USED TO TREAT RETINAL CONDITIONS?

Yes! The use of conventional laser technology at your eye doctor's office has expanded far beyond the realm of LASIK and PRK for vision correction.

 

Today, a variety of specialized lasers are part of the eye surgeon's toolkit for treating a range of conditions affecting the retina (the light sensing membrane lining the back of your eye that transmits images to your brain). Laser treatments are typically administered in your eye doctor's office and are performed in a few minutes with little to no discomfort or downtime needed for recovery.

 

Lasers are used to treat a number of retinal conditions, most notably retinal damage caused by diabetes, known as Diabetic Retinopathy (DR). This condition is fairly common. In fact, 28 percent of diabetics over 40 have some degree of DR. Other common uses for lasers are the treatment of retinal tears or holes and also the treatment of visual floaters.

 

Depending on your vision changes and the severity of your retinal disease, your eye doctor may recommend laser therapy to arrest damage being caused to your eye and prevent further vision loss.

How are lasers used to treat common retinal conditions?

 

Retinal tears and holes

Did you know that there's a 50 percent chance that a retinal tear will progress to a retinal detachment? That's why retinal tears cause so much concern. Today, the majority of retinal tears are treated in the eye doctor's office through a process called laser photocoagulation.

 

Typically, argon lasers are used. They emit light energy to “weld” the edges of a retinal tear or hole against the underlying tissue lining the back of your eye. This stops the retinal tear from developing into a full-blown retinal detachment.

 

Retinal vein occlusion 

Advanced diabetes leads to the growth of abnormal new blood vessels. These vessels can crowd and block (or occlude) veins responsible for draining used blood from the retina. This lack of blood flow can deprive entire retinal sections of oxygen, causing cells to die off. 

 

Argon lasers target the hemoglobin in abnormal blood vessels, causing the hemoglobin molecules to clump and clot off the vessel. By eliminating the abnormal vessels occluding the retinal vein, vision is restored.

 

Proliferative diabetic retinopathy

Lasers are also used to seal leaking retinal blood vessels (known as retinal hemorrhages) that are often seen in advanced diabetes. This restores the circulation and oxygen supply vital for vision preservation.

 

When retinopathy becomes advanced, panretinal photocoagulation is usually recommended. This involves treating large areas of the retina to stop vessels from leaking.

  

Age-related macular degeneration

In some forms of wet macular degeneration, your doctor may combine laser treatment with other therapies in an effort to give you the best chance for retaining your vision.

 

Some of these other treatments may include intraocular injections with steroids or medications, as well as photodynamic therapy.

 

Diabetic macular edema(DME) 

Low energy laser pulses are sometimes deployed as a second line treatment to safely cauterize tiny vessels leaking plasma underneath the retinal surface. This diabetes related condition of a soggy retina is known as Diabetic Macular Edema (also known as “DME”).

 

DME robs retinal cells of oxygen and thus can result in central blurriness, abnormal color vision, and blind spots. The gold standard treatment for Diabetic Macular Edema is injected medication.

 

However, when this option is not possible due to expense or the location of the affected vessel, focal laser treatment is an option.

 

Floaters

Sometimes people experience very bothersome floaters in their visual field that impedes their daily function. These floaters are basically debris from retinal pigment cells (called retinal pigment epithelium).

 

When floaters become particularly troublesome, your eye doctor might recommend using a YAG laser to fragment the floaters into tiny imperceptible pieces.

 

What to expect during laser eye treatments

While each laser treatment can vary depending on the goal of the treatment and the severity of the condition being treated, in general, this is how most retinal laser treatments are performed:

 

Your eye doctor will apply numbing drops and dilating drops to your eye.

 

The laser is then focused to where there is a retinal tear, for example, or a blood vessel that needs to be sealed off. You will experience very bright flashes of light focused on your eye. Your doctor may place a special contact lens on your eye during your treatment.

 

The laser emits a beam of light that travels via laser pulses into the eye, entering through the pupil and creating tiny burns at the precisely targeted treatment site.

 

This creates a scar that, for example, seals a retinal tear or perhaps shuts down a bleeding blood vessel. Each pulse duration is a fraction of a second and the whole treatment usually takes less than 30 minutes. You may experience some mild discomfort during treatment that is often described as an “ache”.

 

Your doctor may place a protective shield over your eye. You will be able to go home following your procedure (you will have been instructed to bring a driver who can take you home).

 

What to expect after a laser treatment

Following your laser treatment, your doctor might place steroid drops in your eye to prevent inflammation. You might be instructed to continue using medicated eye drops at home and perhaps to refrain from strenuous activities for a few days in order to allow scars to form inside your eye and heal. Most patients can go back to work the following day.

 

While most patients don't notice any change in their vision following laser procedures, there are some patients who may experience blurred vision or notice a permanent blind spot or decreased peripheral vision following surgery, depending on the severity of the condition for which they received treatment.

 

You will be asked to return to our office for follow-up in a few days to see how you're healing.

 

Will I need more than one laser treatment?

That depends. Sometimes it can take from weeks to months before we can determine how successful your treatment has been. That said, many patients do require more than one treatment to manage their eye problem and prevent further deterioration of their vision.

 

Why trust AEI for retinal laser surgery

The AEI staff includes a highly skilled retina specialist Dr. Svetlana Pilyugina or “Dr. P”, as she is known to her patients. Dr. Pilyugina is an ophthalmologist with fellowship training and board certification in diseases and surgery of the vitreous and retina.

 

Dr. P has been performing retinal surgery and laser therapy for over a decade and has considerable experience in the treatment of a broad range of retinal conditions.

 

  • Dr. Kerry Assil, Beverly Hills LASIK and Cataract Surgeon

    Kerry K. Assil, MD, is regarded as one of the world’s foremost experts in refractive surgery, having made significant advances in the field with his numerous inventions. Additionally he has the unique distinction of having trained thousands of eye surgeons in the latest refractive surgical techniques.

     

    Dr. Assil has authored more than one hundred textbooks, textbook chapters and articles on refractive surgery and has appeared regularly on major television network news programs as a pioneer in refractive surgery. He also leads educational forums for other eye care professionals, which have included featured lectureships at Harvard University, Johns Hopkins University and Tokyo University.

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