Diabetic retinopathy does not usually impair sight until the development of long-term complications, including proliferative retinopathy, a condition in which abnormal new blood vessels may rupture and bleed inside the eye. When this advanced stage of retinopathy occurs, pan-retinal photocoagulation is usually recommended.
During this procedure, a special laser is used to make tiny burns that seal the retina and stop vessels from growing and leaking. Hundreds of tiny spots of laser are placed in the retina to reduce the risk of vitreous hemorrhage and retinal detachment. Targeted laser applications can treat specific areas in the central vision that are leaking. The laser is used to destroy all of the dead areas of retina where blood vessels have been closed. When these areas are treated with the laser, the retina stops manufacturing new blood vessels, and those that are already present tend to decrease or disappear.
The goal of pan-retinal photocoagulation is to prevent the development of new vessels over the retina and elsewhere, but you may not regain vision that has already been lost.
Pan-retinal photocoagulation is for those:
- who have been diagnosed with proliferative retinopathy
- whose doctor has determined that pan-retinal photocoagulation is the appropriate treatment for their condition
What to expect on procedure day:
Your treatment will be performed in a specially equipped laser room. It does not require a surgery center. It can be performed with or without local injectable anesthetics around the eye.
Before your procedure begins, an eyelid holder or contact laser lens, will be placed between your eyelids to keep you from blinking. Next, your ophthalmologist will begin laser treatment with an argon or diode laser. The laser treats the peripheral (outside) portions of your retina.
The initial treatment usually consists of approximately 1,500-2,000 spots of laser per eye. This will be done in two or more sessions.
Your vision may be reduced immediately after the treatment, but will recover to the pre-treatment level over time. You should plan to have someone drive you home, and you should relax for the rest of the day. Most patients resume activities within a few days. Regular follow-up visits are required.
The goal of pan-retinal photocoagulation is to prevent the development of new vessels over the retina and elsewhere, but may not restore vision that has already been lost. If vision remains worse after the laser, it may be due to edema (swelling) of the retina. Additional treatments with antivegf injectable medications into the eye may be needed. Surgical vitrectomy may be also needed at a later time, but pre-surgery laser can make the surgical vitrectomy safer with better results.
The pan-retinal photocoagulation procedure sacrifices some peripheral vision in order to save as much of the central vision as possible and to save the eye itself. Night vision and ability to focus up close may be diminished. After pan-retinal photocoagulation, blurred vision is very common. Usually, this blur goes away, but in a small number of patients, some blur will continue and likely need additional treatment options.
Serious complications with pan-retinal photocoagulation are extremely rare, but like any surgical procedure, it does have risks. These risks can be minimized by going to a specialist experienced in management of diabetic retinopathy.
Early detection and treatment of diabetic retinopathy is the key to prevention of blindness. Diabetes remains the leading cause of blindness in young and middle aged adults, but it is usually preventable if diagnosed early, preferably even before blurred vision is noticed by the patient.
If you would like more information about this procedure or to schedule your recommended diabetic eye exam, you can make an appointment or contact the office for additional information.