Laser photocoagulation - Prima Health

In , L&#;Esperance was the first to use the Argon laser to treat diabetic retinopathy. In , when Zweng, Little, and Peabody attached the Argon laser system to the slit lamp, whole-retina photocoagulation was easier to perform and more widely available.

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1. Definition

Laser retinal photocoagulation is the use of a laser with a wavelength consistent with the absorption spectrum of the retinal pigment epithelium to coagulate the layers of cells that cause adhesions between the choroidal layer and the retina.

Types of lasers used for retinal photocoagulation

• Argon laser blue, green
• Green Argon laser. This is the most commonly used laser for total retinal photocoagulation
• KTP laser or Nd . laser
• Color laser
• Laser Krypton
• Laser Semiconductor Diode

2. In what cases is laser retinal photocoagulation indicated?

• Treatment and prevention of retinal detachment: retinal tear or retinal hole; Retinal degeneration; The second eye of people with severe myopia has mixed degeneration in which the other eye has had retinal detachment; The ligaments in the vitreous pull the retina&#;
• Treatment of retinal ischemia.
• Treatment of proliferative diabetic retinopathy
• Treatment of retinal neovascularization: age-related macular degeneration, or after chorioretinitis, optic disc neovascularization
• New vessels anterior or adjacent to the papilla.
• New vessels of the retina of medium or large size (>1/4 of the optic nerve)
• Hemorrhage in the vitreous &#; photocoagulation when microvascular malformations are located between the ring exudates in the posterior polar retina
• Macular edema: diffuse, cystic, edematous or partial
• Contraindicated for systemic and ocular diseases that do not allow surgery.

3. Steps to proceed:

• Pupil dilator drops
• Apply local anesthetic to the surface of the eyeball &#; Use Mainster Wide Field contact lenses with 0.2% Lacrinorm gel on the cornea of the eye to be treated. &#; Set treatment parameters

4. Attention after laser photocoagulation

• An eye bandage for 6-24 hours is required if post-ocular anesthesia is required.

• Use mild pain relievers when there is pain. If the patient has a lot of pain, it is necessary to check for acute glaucoma due to choroidal hemorrhage.

• Patients should avoid vigorous activity, bending over or coughing a lot because it can cause rupture of new vessels in diseases with choroidal neovascularization.
• Re-examination after 2-3 weeks to see if the lesions have enough scars, if not enough, add more

Laser peripheral iridotomy

1. Designation

• The patient has a shallow room with a narrow angle.
• One eye has been operated on acute angle closure, the other eye has not closed angle.
• The eye has had acute angle closure episodes but the angle is not open &#; 1/2 of the angle.

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2. Mechanism of action

The laser creates a small hole in the iris periphery, making it easier for the fluid to flow from the back of the iris to the front to reduce pupil blockage.

3 Peripheral iris laser process

1. Prepare patient: instill Pilocarpine 2% pupillary drug 1 hour before laser.
2. Apply local anesthetic before placing Abraham contact lenses (66D).
3. Set treatment parameters

4. Post-surgery

• Monitor intraocular pressure 1-2 hours later
• Topical corticosteroids 4 times/day x 7 days
• Analgesic
• Glaucoma-lowering medicine acetazolamide 250mg 2 tablets / x 2 days.

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Many people assume laser eye surgery is only used to correct refractive error, when in fact, it can also be used to treat a wide range of other eye conditions, especially retinal diseases.

Pan-Retinal Photocoagulation
If blood supply to the retina is disrupted, ischaemic tissues may trigger abnormal vessel growth. This may lead to complications such as vitreous hemorrhage or elevated eye pressure. Pan-retinal photocoagulation, which targets the peripheral retina, can help alleviate the metabolic imbalance, divert nutrients to the macula and preserve central vision. This type of laser treatment is commonly administered to patients with proliferative diabetic retinopathy and ischaemic retinal vein occlusion.

Barrier Laser
Any break on the retina may allow fluid to seep through and ultimately cause retinal detachment. Laser treatment can create a barrier around the retinal degeneration or break to reduce the risk of retinal detachment. Barrier laser can also be used to limit the extent of localized retinal detachment.

Focal Laser
Diseased blood vessels of the retina may leak and lead to fluid collection. If the leaky blood vessel is located outside fovea, ophthalmologists may use focal laser treatment to slow down or prevent leakage. This type of laser treatment is commonly administered to patients with macular oedema as a result of diabetic retinopathy or vascular tumors.

Grid Laser
If there is macular swelling, gentle laser applied in a grid pattern may be used to stimulate the retinal pigment epithelium to pump out the fluid collection. This type of treatment is commonly administered to patients with diabetic macular oedema.

Advancements in Retinal Laser Treatment
The pattern scanning laser system can be used to deliver laser energy in a preselected scanning pattern, thereby shortening treatment times. Micropulse laser technology delivers short energy pulses separated by rest periods, allowing treated eye tissues to cool down in order to minimize thermal damage. Laser in the yellow light spectrum has high penetration power with low level of scattering, achieving the same therapeutic effect with less energy. Thanks to continued advancements in medical technology, retinal laser treatment has become safer, more accurate, effective and comfortable for patients.

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