Retinal laser or PRP
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What is retinal laser (PRP)?
Laser treatment is performed in a doctor’s office or ophthalmology clinic. Before the laser procedure, the doctor dilates the patient’s eyes and uses eye drops to numb them. In a darkened room, the patient sits in front of a laser machine, and the doctor places a special lens on the eye, concentrating high-energy laser beams on the retina. During the laser treatment, the patient may see flashes of light, which can sometimes cause burning and discomfort.
After the laser treatment is complete, the patient can leave the clinic but will need someone to take them home. Since the eyes remain dilated for a few hours, the patient should use sunglasses. It is likely that the patient’s vision will be somewhat blurry until the end of the day, and if they experience burning or eye pain, they can consult their doctor for treatment. Doctors use laser treatment for severe swelling, yellow spots, and advanced retinopathy.
Laser therapy typically does not restore lost vision, but it prevents further visual impairment.
Yellow spot swelling
Timely laser treatment can reduce the extent of vision impairment resulting from yellow spot swelling by half, but for controlling fluid leakage, some patients may require laser treatment more than once. In this treatment method, high-energy laser beams cause the closure of the leaking blood vessels in the center of the retina. As mentioned earlier, laser therapy, in general, prevents further visual impairment but usually does not restore lost vision.
In this type of condition, laser therapy is also used to eliminate new abnormal blood vessels. However, the method differs from the previous one, and instead of localized laser treatment on specific points in the center of the retina, laser burns are created in an area away from the center of the retina. This leads to a reduction in the growth factors of blood vessels and causes the extra vessels to regress.
In this approach, there is a brief reduction in peripheral vision, night vision, and color discrimination. Patients with “proliferative diabetic retinopathy” are constantly at risk of new bleeding. This means that, to preserve vision, sometimes multiple laser treatments are necessary.
Possible side effects of laser therapy
Laser retinal therapy in diabetes may lead to some degree of reduced peripheral vision, diminished contrast sensitivity, decreased night vision, light intolerance, and decreased color discrimination. During laser treatment, there is usually mild, tolerable discomfort in the eyes, which can be controlled with specific medications. Overall, extensive studies conducted worldwide have demonstrated that individuals undergoing laser treatment have benefited significantly compared to those who have not received laser therapy, and their vision has been preserved.
Intraocular injections of medications
A: In cases where yellow spot swelling is severe or hasn’t responded to previous laser treatments, intraocular injections can be used.
B: Additionally, in cases where extra blood vessels do not regress despite laser therapy or when vitreous hemorrhage recurs, intraocular injections of medications specifically designed for this purpose can be used. Intraocular injections are performed in the operating room under sterile conditions.
Vitrectomy (removal of the vitreous gel)
Vitrectomy (removal of the vitreous gel): Sometimes, instead of laser treatment, a specific surgical procedure called vitrectomy is necessary to preserve vision. Vitrectomy is performed when there has been prolonged presence of significant blood in the vitreous or when retinal detachment is caused by the growth of fibrous tissues on the retina. In this surgery, the cloudy vitreous gel is removed.
Statistics show that individuals with type 1 diabetes (insulin-dependent diabetes) who undergo vitrectomy immediately after severe bleeding have less visual impairment compared to those who delay the procedure. Vitrectomy can be done under general or local anesthesia. During the surgical procedure, the doctor creates a very small incision in the white part of the eye (sclera) and inserts a small instrument into the eye to remove the vitreous and replace it with a special saline solution. In cases where retinal detachment is also present, both the vitreous and extra tissues from the retina are removed, and the retina is reattached to its original position using a gas or silicone oil injection in place of the removed vitreous. After the surgery, the patient may return home or spend the night in the hospital. The patient’s eye becomes red and sensitive after the operation, and they should use an eye shield for protection for several days to weeks. Eye drops are also prescribed to prevent infection and reduce inflammation.