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Photocoagulation for diabetic retinopathy, retinal tears, and macular disorders — what to expect before, during, and after.
Pan-Retinal Photocoagulation (PRP) is a laser treatment used for advanced diabetic retinopathy, particularly when new, abnormal blood vessels have formed on the retina (proliferative diabetic retinopathy) or in the drainage angle of the eye.
These fragile new vessels (neovascularisation) are prone to bleeding, causing vitreous haemorrhage and potentially retinal detachment. PRP laser destroys the oxygen-deprived peripheral retina, eliminating the signal that drives new vessel growth.
Goal: PRP does not restore lost vision, but it significantly reduces the risk of further vision loss from vitreous haemorrhage and traction retinal detachment. It is a sight-saving, not sight-restoring, procedure.
Focal laser targets individual leaking microaneurysms in the macula (the central retina responsible for fine detail vision). Grid laser applies a grid pattern of laser burns to areas of diffuse retinal oedema.
These techniques have largely been complemented by anti-VEGF injections for diabetic macular oedema, but laser remains useful for focal leaks and as a combined therapy to reduce injection frequency.
| Feature | Laser (Focal/Grid) | Anti-VEGF Injection |
|---|---|---|
| How given | Laser light through slit lamp | Fine needle into vitreous |
| Sessions needed | Often 1–2 sessions | Multiple (monthly) |
| Best for | Focal leaks, mild/moderate DMO | DMO with central involvement |
| Vision improvement | Stabilises, modest improvement | Often significant improvement |
Retinal tears and holes are weak spots in the retina through which fluid can seep underneath, causing the retina to detach. Retinal detachment is a serious emergency that can result in permanent vision loss.
Preventive laser barricade creates a ring of laser burns around the tear or hole. These burns form a scar that seals the retina to the underlying tissue, preventing fluid from entering and causing detachment.
Urgent warning: Sudden onset of many new floaters, flashes of light, or a curtain/shadow across vision should prompt same-day or next-day ophthalmology review. Treated early, a tear can be sealed with laser. Left untreated, it can progress to retinal detachment requiring major surgery.
Follow-up is scheduled 1–4 weeks after laser to confirm the reaction is satisfactory and the retina is sealed.
Book an appointment with Dr. Laavanyaa at SRM Prime Hospital or P&G Multispeciality Hospital, Chennai.