Today’s laser surgery represents a major advance in treating eye disease in people with diabetes. The most widely used lasers – the blue-green argon and the green-only argon – are safe and convenient for laser surgery. Two major types of laser surgery are performed:
- Scatter or panretinal photocoagulation, in which the skilled ophthalmologist places hundreds of tiny “burns” on the retina with the laser, avoiding the macula, the area of the eye responsive for precise vision. This technique is used to treat proliferative diabetic retinopathy, a major cause of severe visual loss from diabetes.
- Focal laser surgery, which is used to treat diabetic macular edema. Using a technique called fluorescein angiography and other examination and photographic techniques, the ophthalmologist identifies areas that are leaking fluid into the macula. These areas are then treated directly with a laser to prevent further leakage of fluid into the macula and to allow fluid that has already leaked to be reabsorbed.
Laser treatment may cause the patient some temporary discomfort, but usually, the surgery is done on an outpatient basis in the ophthalmologist’s office. After treatment, you may experience a slight decrease in vision or it may be a little harder for your eyes to adapt to the dark, a side effect that diabetes itself may cause. But the overall benefits of the laser treatment far outweigh these relatively minor drawbacks. Laser surgery and appropriate follow-up care preserve vision and reduce the risk of severe vision loss to less than 5%.
If hemorrhage does occur and vision is lost, or if the scar tissue threatens to detach the retina from the back of the eye, vitrectomy surgery can frequently successfully restore vision. A vitrectomy is performed under either local or general anesthesia. The doctor makes a tiny incision in the eye. Next, a small instrument is used to remove the vitreous gel that is clouded with blood.
The vitreous gel is replaced with a salt solution. Because the vitreous gel is mostly water, you will notice no change between the salt solution and the original vitreous gel. You will probably be able to return home after the vitrectomy, and you will need to wear an eye patch for a few days to protect your eye. You also will need to use medicated eye drops to protect against infection.
Thanks to this procedure, many people who once were totally blind can see. Both laser treatment and vitrectomy are very effective in preserving vision.