Laser Photocoagulation for Age-Related Macular Degeneration

What is laser photocoagulation for age-related macular degeneration?

Laser photocoagulation is a type of laser surgery for the eyes. It is done to treat age-related macular degeneration (AMD). AMD is a condition that can lead to loss of vision.

The retina is the layer of cells in the back of your eye that converts light into electrical signals. Your retina then sends these signals to your brain. AMD affects your macula. The macula is the sensitive, central part of your retina. This area is responsible for the detailed vision in the middle of your visual field. AMD damages your macula. The macula may become thinner and have deposits of material. Blood vessels may start growing into your retina. This can cause fluid to leak beneath your macula and your retina. This excess fluid can lead to vision loss.

Before the surgery, you are given a local anesthetic that affects only your eye area. A doctor then uses an intense beam of light to burn small areas of the macula. This seals off the leaky blood vessels. This can help prevent more vision loss.

Why might I need laser photocoagulation for age-related macular degeneration?

Laser photocoagulation is one type of treatment for AMD. AMD is a common cause of severe vision loss in older adults. In rare cases, it can result in total blindness. Because AMD affects the macula, you may still have your side (peripheral) vision. But you may have a gradual or sudden loss of central vision.

AMD has two types: dry type and wet type. Abnormal blood vessel growth is present in only the wet type. Laser photocoagulation is advised only for the wet type of the disease. Laser photocoagulation is only an option for certain people with wet type AMD. Your doctor might advise the procedure if your abnormal blood vessels cluster tightly together. The procedure is less helpful if you have scattered vessels. It is also less helpful if they are in the central area of the macula. Your doctor may be more likely to advise the procedure if your vision loss comes on suddenly instead of slowly.

Laser photocoagulation cannot restore vision that you already have lost. But it may slow down the damage to your central vision.

Other treatment options for AMD include drugs that decrease abnormal blood vessel growth. Your healthcare provider may advise the use of drugs and laser photocoagulation. Talk with your healthcare provider about the risks and benefits of all of your treatment options.

What are the risks for laser photocoagulation for age-related macular degeneration?

During laser photocoagulation, the doctor burns away part of the macula. This often results in some additional vision loss. You might have a blind spot where the laser creates a scar. In some cases, this vision loss might be worse than the potential vision loss from not treating the eye. This is something to think about when planning to have the surgery.

The procedure has some other possible risks as well. These include:

  • Accidental treatment of the central macula (which causes a worse blind spot)
  • Bleeding into the eye
  • Damage to the retina from the laser scar (immediately or years later)

There is also a risk that the abnormal blood vessels might grow back. If this happens, you might need to repeat the treatment.

Your risks may differ according to your age, your general health, and the type of your AMD. Ask your healthcare provider which risks apply most to you.

How do I prepare for laser photocoagulation for age-related macular degeneration?

Ask your doctor what you need to do to prepare for laser photocoagulation. Ask your doctor if you need to stop taking any medications before the procedure. Ask when you need to stop eating and drinking prior to the procedure.

Your doctor may want to use special instruments to shine a light in your eye and examine the back of your eye. You may need to have your eyes dilated for this eye exam. Your doctor might order other special tests to get even more information about your eye. These might include:

  • Fluorescein dye retinal angiography
  • Optical coherence tomography
  • Fundus autofluorescence

Before the procedure, eye drops will be used to dilate your pupil. It will stay dilated for several hours after the procedure.

What happens during laser photocoagulation for age-related macular degeneration?

It is most often done as an outpatient procedure in a doctor’s office or eye clinic. During a typical procedure:

  • Most people are awake during the procedure. You may receive a medication to help you relax. The doctor may use anesthetic eye drops and injections to make sure you don’t feel anything.
  • Less commonly, some people receive anesthesia that puts them to sleep. If this is the case, you will sleep deeply through the surgery and won’t remember it afterwards.
  • Someone will put a special type of contact lens into the affected eye, after you have had numbing drops placed on the eye. This lens helps focus a beam of laser light on the retina using something called a slit lamp.
  • The doctor uses the laser to seal off the abnormal blood vessels beneath the macula.
  • Someone may temporarily cover your eye.

What happens after laser photocoagulation for age-related macular degeneration?

Ask your doctor about what you should expect after your surgery. You should be able to go home the same day. Plan to have someone go home with you after the procedure.

Be sure to follow your doctor’s instructions about eye care and medications. Your eye may be a little sore after the procedure, but you should be able to take over-the-counter pain medications. You may need to wear an eyepatch or dark glasses for a day or so. Ask your healthcare provider whether you should avoid any specific activities as you recover.

You will need close follow-up care with your doctor. He or she will monitor you for complications and continue to manage your treatment for AMD. Be sure to tell your doctor right away if you have decreased vision or increased eye redness, swelling, or pain.

Your vision may be blurry for a short while after the surgery. Remember that the surgery does often cause an area of new vision loss. But in the long term it may help prevent your vision from getting worse.

Next steps

Before you agree to the test or the procedure make sure you know:

  • The name of the test or procedure
  • The reason you are having the test or procedure
  • The risks and benefits of the test or procedure
  • When and where you are to have the test or procedure and who will do it
  • When and how will you get the results
  • How much will you have to pay for the test or procedure