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.

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.