LASER RETINA COAGULATION
This treatment option is the only one and having no alternative when the retina is damaged in diabetic persons, in case of the fundus pathology, after the eye vascular diseases, in case of a high myopia, and retina local detachment.
An OcuLight TX ophthalmologic laser device produced by IRIDEX (USA) is used for the retina pathology treatment at our center.
HOW LASER COAGULATION IS PERFORMED?
- A laser retina coagulation is performed outpatiently (no hospitalization) under a local anesthesia (after special eye drops have been instilled).
- A special lens (three-mirror Goldman’s lens) is applied allowing focusing the laser beam on any area of the fundus.
- The laser beam moves through a slit lamp, and the surgeon can control the procedure course via a stereomicroscope and bring the laser beam into focus.
- The laser demonstrates a high accuracy and is used for binding the retina and the eye vascular membrane (i.e. for the retina reinforcement).
What the procedure is targeted at ?
The procedure is targeted at “binding” the retina to the adjacent tissues and creating an adhesion making impossible for the retina to detach. The retina is applied in 3 – 5 laser coagulate rows around the pathologic focus. Then, a chorioretinal binding forms and blocks the retina detachment progress.
The effect may be compared with the wallpaper: when wallpaper is coming unstuck, it is stuck to prevent from unsticking completely. The same is done with the retina: a coagulation procedure reinforces it to prevent the detachment that can result in a full vision loss.
Laser coagulation is practically pain-free. A patient is required to sit quietly, as the laser surgeon performs the procedure under a large magnitude controlling thoroughly the coagulate appliance on the retina tissue. What are sensations of the procedure?
About 10 – 14 days are necessary for a hard chorioretinal binding’s formation. Lack of retina detachment progressing, its distribution outside the margins of the coagulates allow considering the procedure successful.
ACTIONS AFTER LASER COAGULATION
Preventive examinations of the both fundus periphery under the pupils dilated should be performed in patients having passed the successful preventive laser coagulations at least once half a year, when the physician recommends it in order to identify new areas of degenerated retina or the retina thinning and rupture in the earlier treated areas. Preventive laser coagulations in such areas will allow reducing the risk for retina detachment and avoid vision functions’ loss.
DISEASES CALLING FOR LASER COAGULATION
In order to prevent diabetic retinopathy development resulting in a weaken vision and blindness, diabetic persons are going through laser retina coagulation. More extensive laser coagulation has to be performed in diabetic patients with identified retinopathy. Coagulants are applied to the whole retina, except the central area. The procedure is made in several stages – usually three to six.
In a number of cases, the retina is coagulated with a laser in patients with the retinal central vein thrombosis or with its branches’ thrombosis in 2 – 3 months after the major treatment. In such cases, laser coagulation allows reducing the risk for a secondary glaucoma development and the retinal edema, if any.
Moreover, non-compensated glaucoma is treated using a laser after every possible hypotensive drug has been tried in order to postpone a surgical management: an exposure in the anterior chamber angle leads to the intraocular pressure reduction.
The wavelength of the OcuLight TX laser is 532 nm, making possible for efficient removal of eyelid benign masses (papilloma, nevus, hemangioma, verrucous viral masses). After they have been removed, a flat dark crust remains, and it will be separating in 1 – 2 weeks. The procedure is carried out in one step and takes 5 – 20 minutes on the average.
CONSULT FOR BEING TREATED IN DUE TIME
Unfortunately, some patients consult a physician for being treated when the process is rather advanced, and laser coagulation cannot stop the process or is even contraindicated. As a rule, extensive intraocular hemorrhages and retinal detachment are the causes of the vision acute worsening. Nothing, but surgical management is possible in such cases.
The fundus state systemic control, physical overloading and eye damage exclusion, blood pressure normalization allow preventing the retina detachment when the fundus demonstrates dystrophic changes.