For patients who are have advanced retinopathy but who do not need to have a vitrectomy laser treatment is the surgery that is usually recommended.
There are 2 types or methods of laser surgery.
- Focal Laser Treatment
- Scatter Laser Treatment
Focal laser treatment (photocoagulation) is an out patient procedure that will usually be performed right in your doctor’s office and usually takes a very short amount of time.Â Only one session is needed for focal laser treatment and this method has been around used successfullyÂ for many years.
The aim is to stop leakage of blood and other fluids into the eye and the method this treatment uses is to cauterize leaks in the vessels sealing them closed.
Spots from the cauterization can affect vision for some time after the procedure but these usually fade in time.
Scatter laser treatment (panretinal photocoagulation) is used in more serious and advanced cases. It uses the same technology as focal laser treatments but the aim is to get stop and reverse the growth of any new blood vessels that have developed due to the effects of diabetic retinopathy. It accomplishes this by burning the effected areas way from the macula so that they shrink.
By shrinking the abnormal blood vessels retinal detachment is avoided and vision can be saved. Night vision and peripheral (side) vision can be reduced by this procedure.
Usually if you need to have scatter laser treatments multiple sessions will be involved (commonly 2 – 4 sessions).
With all outpatient procedures involving dilation of the eyes and especially laser and vitrectomy surgeries the patient should make sure they have someone who will drive them to and from the procedure as vision will be too poor to drive.
Diabetic retinopathy usually affects diabetics from age 20 and up but don’t wait to get tested because the symptoms may not manifest themselves until it’s too late.
Retinopathy can be causing damage for may years before the symptoms are noticed as can be seen through the experience of a pregnant mom in the following video.
Vitrectomy surgery is one of 2 main medical treatments for Diabetic Retinopathy.
The other alternative (preferable to most people) is laser surgery.
Vitrectomy surgery usually takes about 2 – 3 hours to perform and while it usually takes place on an out patient basis your physician may determine that the procedure take place on an inpatient basis usually with only an overnight or 24 hour stay.
Your doctor will also usually determine whether the operation can be done using only a local anesthetic or whether general anesthesia will be required. In some cases he/she may leave the decision to the patient.
The actual procedure involves removing the vitreous gel from the eye in order to perform repairs to the retina including repairing tears and holes to both the macula and the retina, flattening areas of the retina that have pulled away from the retinal wall, and removing abnormal tissues, both fibrous and scar, from the retinal wall.
In this procedure small cuts are made to the eye in order to get to the affected areas and many times a laser is used to remove the abnormal tissues and stop the growth of abnormal veins.
After the necessary repairs are made the vitreous gel may be replaced with a gas bubble which will eventually dissolve on it’s own and be replaced by the body’s own fluids.
If the body does not replace it a silicone oil is used. However this replacement is temporary and if used it is necessary to have a follow up operation in order to remove it.
After the operation, in order to facilitate proper healing, most people need to reduce their activity for a short time (usually a few days) and the physician will make specific recommendations.
Improved vision will normally take place within a few weeks but can take several months. Blurred vision is nomal and most patients that undergo this procedure recover enough to resume their regular work and activities / lifestyle within about 4 weeks of receiving the operation.
For a short video of a woman that underwent the operation click here.
The following video explains simply and clearly what diabetic retinopathy does, some of the symptoms, and provides nice illustrations to better understand what is happening in your eyes if they are affected by diabetic retinopathy.
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