Laser coagulation of the retina: modern possibilities of treating eye pathology

2023 Author: Alfred Shackley | [email protected]. Last modified: 2023-05-21 13:14

The eye is a complex and sensitive human organ. With its help, we receive the bulk of information about the world around us. Under the influence of various provoking factors, the inner shell of the eye - the retina, can exfoliate from the choroid. This leads to visual impairment, and without adequate treatment, blindness.

Laser coagulation (restrictive or prophylactic) is a method that allows you to correct and promptly stop the degenerative processes of the retina.

Symptoms and signs of the disease

The retina is the inner lining of the eye; it perceives visible electromagnetic radiation and promotes its transformation into nerve impulses.

This membrane is closely connected by its inner side with the vitreous humor of the eye, and its outer surface is adjacent to the vascular part of the eyeball.

When the retina is detached and ruptured, the following symptoms occur:

• a veil before the eyes;
• lighting effects: flashes, lightning, sparks, especially when you close your eyes;
• distortion of objects, their partial falling out of the review.

After sleeping, the patient notices an improvement in vision, this is due to being in a horizontal position, when the retina returns to its place. Having taken an upright position, the patient again experiences the listed symptoms. Peripheral restrictive paravasal laser coagulation of the retina can help restore clarity of vision.

Causes of retinal disease

The separation of the inner lining of the eye occurs for various reasons, it occurs after injury to the organs of vision or is provoked by a disease.

Among the main factors, doctors indicate:

• dystrophy, or thinning of the retina;
• changes in the state of the vitreous body, the appearance of seals due to various eye diseases, pulling and tearing the retina;
• diabetic retinopathy;
• tumors.

Indications for the operation:

1. Diabetic retinopathy, the ability to prevent the destruction of the retina.
2. Dystrophic changes or proliferation of blood vessels.
3. Peripheral retinal dystrophy - damage to the cells of the inner membrane, causing peripheral detachment.
4. Lattice retinal detachment - tears and thinning are located between the vessels.
5. The emergence of various types of tumors.
6. Violation of ocular refraction, which is accompanied by myopia.

Contraindications

Like any surgical intervention, laser coagulation is not prescribed for all patients. Restrictions apply to the following conditions:

• low vision (0.1 diopters);
• significant opacity of the vitreous body of the eye;
• pathological proliferation of vessels of the iris;
• symptoms of fundus hemorrhage.

Treatment methods

Retinal detachment is not treated with medication, the only way to preserve the patient's vision is to perform an operation on time. One way to do it is by using a laser.

The goal of surgery is to find and repair the retinal tear by creating adhesions. The operation is performed on an outpatient basis, under local anesthesia, which is performed by instilling an anesthetic into the eye.

To direct the beam of the device to the desired place, a special contact lens is used. Goldman's three-mirror lens creates laser focusing on the affected area.

There are several types of procedures.

Peripheral retinal laser coagulation

In some cases, the laser coagulation procedure is carried out for prophylactic purposes. The operation prevents detachment of the retina and strengthens it. With the help of a laser-coagulator, the shell is soldered to the wall of the eyeball, when a dangerous degeneration of the retina of the "lattice" or "snail trace" type is detected.

Restrictive laser coagulation causes microburns, which contribute to the soldering of the separated area with the tissues of the choroid. This procedure has been carried out for about 40 years, helping to preserve the eyesight of patients. Enough one session lasting 15-20 minutes.

The safety of the operation is evidenced by the fact that restrictive laser coagulation is performed for pregnant women. It is indicated for peripheral dystrophy of the ocular membrane. This problem leads to a prohibition on giving birth naturally, as high stress can cause retinal rupture. After undergoing an examination by an ophthalmologist and detecting vision pathology, a woman has up to 35 weeks to correct the retina with a laser.

Peripheral restrictive laser coagulation prevents stretching and detachment of the retina, strengthens its structure.

After the operation, visual acuity does not increase, it depends on concomitant eye pathologies. Restrictive laser coagulation improves the blood supply to the eye, excludes the ingress of fluid under the retina, and normalizes the nutrition of the membrane. It prevents dystrophic tissue changes and loss of vision.

Barrier laser coagulation of the retina

The procedure is performed around the resulting tears in the inner lining of the eye. It limits the detached areas, creating a kind of barrier. This type of intervention is common with flat local exfoliation.

Additional coagulation

It is performed at the site of retinal rupture after surgery.

Dates in which the operation is performed

At various stages of the disease, doctors determine the urgency of the surgical intervention:

• dystrophy with a local retinal detachment - within the next few days;
• thinning without rupture - a period of several weeks;
• detection of traction without detachment - prophylactic restrictive laser coagulation is required in the coming months.

Postoperative period

After laser coagulation of the retina, the patient does not need a long recovery period. This is the most gentle method of influencing the visual organ. The consequences of the operation are redness and irritation of the eyes, which will disappear after 3 hours. But doctors will definitely give some recommendations, the duration of the recovery period depends on their implementation.

Restrictions after surgery include:

• refusal to drive vehicles for several days;
• eye protection from the sun with special glasses;
• exclusion of activities associated with vibration, weight lifting, bending;
• do not visit baths and saunas for 3-4 days;
• reduce the consumption of liquids, alcohol, spicy foods;
• limit the time at the computer, reading books, watching TV.

It will take 10 to 14 days for a high-quality adhesion to form after the operation. During this period, it is necessary to monitor the condition of the eyes, because unforeseen consequences and complications are possible.

These include:

• curvature of the contour of the pupil;
• deterioration in night vision;
• corneal edema (shortly after surgery);
• increased intraocular pressure.

Prophylaxis

After restrictive laser coagulation, the doctor prescribes an eye examination 2 times a year. It is carried out to timely identify new areas of degenerative tissue changes.

Patients with diabetes should see an ophthalmologist monthly for six months. Further, the number of visits is reduced to 1 time in 3 months. During the examination, a preventive examination of the fundus is carried out to detect areas of retinal thinning.