Treatment in advanced stages of diabetes-related retinal damage using panretinal laser (PRP) applied to the periphery of the retina, reducing the risk of new blood vessel formation and bleeding.
Indication
- Proliferative diabetic retinopathy (advanced stage with new vessel formation)
- High-risk non-proliferative diabetic retinopathy
- Recurrent vitreous hemorrhages
- Iris neovascularization (rubeosis iridis) and neovascular glaucoma risk in diabetes
- Vision-threatening macular edema, with focal/grid laser added to anti-VEGF therapy
- High-risk periods such as pregnancy when retinopathy can progress rapidly
Preparation
- Detailed retinal examination, OCT, and fundus fluorescein angiography if needed
- Bringing blood sugar, blood pressure, and cholesterol values under control
- Pupil dilation with eye drops before the procedure
- Arranging a companion since driving will not be possible for several hours afterward
- If anti-VEGF therapy is ongoing, planning the timing with the physician
How it's performed
- The patient is seated in front of the laser device, with chin and forehead supports in place
- An anesthetic drop is applied to the eye surface and a special lens is placed
- Numerous small laser shots are applied to the periphery of the retina (panretinal photocoagulation, PRP)
- If macular leakage and edema are present, focal or grid laser may be added
- The treatment is completed in a single session or usually divided into 2-3 sessions
- In selected patients, treatment is planned alongside anti-VEGF injections
Post-procedure
- The procedure is outpatient; the patient is sent home the same day
- Light sensitivity and mild blurring may occur for a few hours after laser
- Strict monitoring of blood sugar, blood pressure, and kidney values
- Retinal examination every 4-12 weeks based on the eye's condition
- Additional laser or alternative treatments are considered if new vessel formation does not regress sufficiently
Risks
- Temporary blurred vision and decreased night vision
- Visual field constriction, especially in patients receiving extensive laser
- Mild changes in color and contrast perception
- Very rarely, increased macular edema or small hemorrhage
- Risk of permanent vision loss if existing diabetic macular edema is left untreated
FAQ
Does laser treatment completely cure diabetic retinopathy?
Laser is not used to reverse existing diabetic retinopathy but to reduce new vessel formation and bleeding that cause vision loss in advanced stages. The fundamental treatment is long-term control of diabetes, blood pressure, and cholesterol.
Is the laser painful?
Most patients perceive the procedure as mild pressure and flashes of light. Some may experience stinging or a temporary headache; if needed, regional anesthesia injection may be added.
Will I still need anti-VEGF injections after the laser?
This decision is made individually by the physician. In some patients, laser alone is sufficient, while in cases with macular edema or extensive new vessel formation, laser and anti-VEGF therapy may be planned together.
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