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* Ocular Anatomy And Function

* Two Kinds Of Diabetic Retinopathy

* Fluorescein Angiography

* Nonproliferative Diabetic Retinopathy (NPDR)

* Early Diagnosis Of Nonproliferative Diabetic Retinopathy (NPDR)

* Laser Surgery For Nonproliferative Diabetic Retinopathy (NPDR)

* Proliferative Diabetic Retinopathy (PDR)

* Laser Surgery For Proliferative Diabetic Retinopathy (PDR)

* Vitreous Hemorrhage

* Traction Retinal Detachment

* Closure Of Macular Vessels

* Preventing Diabetic Retinopathy

* Emotional Factors In Diabetes

* FAQ's About Laser Surgery

* FAQ's About Vitrectomy Surgery For PDR

Laser Surgery for NPDR.

The laser is used to stop abnormal retinal blood vessels from leaking fluid into the retina. Vision does not usually improve with laser, but laser can frequently stop further loss of vision. When the swelling of the retina or amount of exudate in the macula has reached a critical stage, laser should be done so that vision does not deteriorate further. Your own doctor can help you evaluate your chances with laser and discuss the options with you.

Focal Laser Surgery.

There are two types of laser surgery for NPDR: Focal (or specific) surgery and Grid surgery. With focal laser surgery, the specific leaking spots in the retina are found by a fluorescein angiogram, which is then used as a guide for the laser in an attempt to stop the leakage. In some patients, all of the leaking spots may be properly treated. In some patients, all of the leaking spots may be properly treated, but they may continue to leak, or new ones may develop. In such cases, further leakage causes more swelling and worsening of vision. Additional laser surgery frequently needs to be done in order to stop new leakage, but again, the vision is not likely to improve. In other situations, further laser surgery is not helpful and should not be done.

In some cases of NPDR, blood vessels appear to be leaking everywhere in the macula and not just in a few specific areas. In such cases, a scatter of laser in a grid pattern is placed across the entire swollen macular area. Grid laser surgery has a fair chance of drying the macula and holding vision stable. Grid surgery, however, infrequently improves vision. Again your doctor will help you evaluate whether specific (focal) or grid surgery, or a combination of the two, is best.

Grid Laser Surgery.

After the laser surgery, the patient will often see the many small spots caused by laser burns. With time, the spots tend to shrink and fade, and the patient will be less bothered by them, though they will always be there.

Even when laser surgery has successfully sealed the leaking vessels, new areas of leakage frequently appear later, causing more swelling and more loss of vision. The patient who is treated with laser should continue to check the vision in each eye daily and tell the doctor immediately if there are new changes, such as a return of distortion or blurriness. Vision does not usually improve with laser surgery, but if NPDR is discovered early enough, laser surgery may stop further loss.


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