Retinal lasers are used to treat a variety of retinal conditions, including diabetic retinopathy, retinal tears, retinal holes, and macular edema. The primary types of retinal laser treatments include:
Pattern: Hundreds to thousands of laser burns across the peripheral retina
Effect: Reduces VEGF production by destroying ischemic retina, preventing further neovascularization and reducing the risk of vitreous hemorrhage or tractional retinal detachment.
Post-Treatment Considerations:
Side effects: Peripheral vision loss, night vision reduction, mild discomfort
Sessions: May require multiple sessions
Focal or Grid Macular Laser (FML)
Indication:
Diabetic Macular Edema (DME)
Macular edema from retinal vein occlusions
Procedure:
Focal laser: Directly targets microaneurysms to reduce leakage.
Grid laser: Applied to areas of diffuse edema outside the fovea.
Effect:
Stabilizes vision by reducing fluid leakage but does not improve vision significantly.
Anti-VEGF injections (e.g., bevacizumab, ranibizumab, aflibercept) have largely replaced focal laser for center-involving DME.
Retinal Tear or Hole Laser (Barricade Laser)
Indication:
Retinal tears
Retinal holes
Lattice degeneration with high risk of detachment
Procedure:
Laser type: Argon or diode laser
Technique: Creates a circular barrier of laser burns around the retinal tear to induce chorioretinal adhesion.
Effect: Prevents progression to retinal detachment by sealing the tear.
Post-Treatment Considerations:
Success rate: High if performed before detachment occurs.
Minimal side effects: Temporary blurring, mild discomfort.
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