Laser therapy
micropulse laser treatment of the retina, vitreolysis, laser treatment of glaucoma.
What is micropulse laser treatment of the retina?
Micropulse laser treatment of the retina is one of the most modern treatment methods. Technology, precision, safety, innovation are just some of the features of laser therapy. The yellow light emitted by the laser goes straight to the retina. This type of laser is not absorbed by the yellow pigment of the macula; therefore, it is a more accurate and safer therapy for treating retinal diseases.
Indications for micropulse therapy include macular oedema secondary to retinal vascular occlusion and diabetic maculopathy. Thanks to the low-power technology used in the laser pulses, this treatment is completely safe as it does not heat up the tissue. Micropulse therapy does not cause blind spots in the visual field or damage of the uvea.
Is micropulse laser therapy of the retina safe?
Modern technology makes micropulse therapy with the right laser light less painful and safer than the lasers previously used for such therapy.
Technological advances have contributed significantly to the accuracy of treatment and comfort during the procedure. The yellow laser uses less energy but does not diminish the effect. Previously, laser treatment of retinal diseases was associated with high risks. The laser micropulses used today are designed to safely and effectively treat macular conditions. While the laser is not emitting micropulses, tissue cooling occurs. This ensures that thermal damage does not occur.
What conditions can be treated with the micropulse laser?
- Diabetic macular oedema, DMO
- Macular oedema during retinal vein occlusion – RVO (central retinal vein occlusion – CRVO or its branches – BRVO)
- Central serous retinopathy – CSR
Diabetic macular oedema (DMO) – is a reduction in the quality of vision by people who have long-term high blood glucose levels. If left untreated, macular oedema can cause loss of vision even in patients of working age. Very severe visual impairment or blindness can occur if the condition is underestimated. Therefore, regular examinations are important, and any symptoms should be consulted with a specialist.
Ophthalmologists can perform the micropulse laser procedure to treat diabetic macular oedema. Continuously elevated blood glucose levels damage the small blood vessels in the eye over time. They begin to leak, leading to retinal oedema. Some of them may close, and this results in hypoxia. Starting treatment in a timely manner can permanently maintain vision. Laser therapy involves improving oxygenation of the inner layers of the retina and reducing swelling. It does not need to be performed as frequently as intravitreal injections.
Macular oedema during retinal vein occlusion – RVO (central retinal vein occlusion – CRVO or its branches – BRVO) – the formation of a thrombus in the vein may indicate atherosclerotic changes. These occur in the central retinal artery. They cause it to harden, which contributes to increased pressure on the retinal vein walls. This causes disturbances in blood flow. Factors that increase the risk of retinal vein occlusions include hypertension, hyperlipidaemia, diabetes, glaucoma and protein S and C deficiency.
Central serous retinopathy – CSR – is a common form of maculopathy or macular disease in patients between 30 and 50 years of age. This condition is characterised by retinoschisis in the macular area and results in the accumulation of subretinal fluid.
The main causes of CSR are increased vascular permeability and increased hydrostatic pressure in the perivascular space of the uvea. Several different factors can cause this, including the use of certain medications or autoimmune diseases. In addition, excessive stress, hypertension and alcohol abuse must be eliminated. Disturbing symptoms that may indicate serous retinopathy are blind spots, haziness, change in size and shapes of objects. The doctor checks for pathological changes during the examination. CSR is suggested by the empty space between the neurosensory retina and the pigment epithelium (on OCT evaluation of the maculae) and the patient’s symptoms.
What is vitreolysis?
Vitreolysis is a procedure to remove the opacities in the vitreous body that fills the eyeball. Its structure is gelatinous and transparent. The function of the vitreous body is to protect the retina, and opacities appearing in the vitreous may indicate inflammation inside the eye. Uveoretinitis and retinal tear and detachment are dangerous conditions that may be accompanied by vitreous opacities.
What does vitreolysis procedure look like?
Vitreolysis procedure is performed on patients after a medical consultation. The specialist determines the condition of the vitreous body and presence of opacities. Vitreolysis is painless, and no major complications have been observed in patients. Of course, every case is different, and you should consult your doctor about any concerns. Possible complications that pass after a few days include burning and blurred distance vision. The improvement is already visible over the next few days.
Vitreolysis procedure in 3 steps
A thorough medical consultation follows:
- Corneal anaesthesia and pharmacologic dilation of the pupil.
- Patient looking in a direction imposed by the doctor so that the opacities can be visualised.
- Seeing laser flashes.
The patient should listen to the instructions of the doctor performing the vitreolysis. The preparation and the treatment itself take about 1 hour, so it is worth reserving more free time in advance. After vitreolysis, up to a few hours may be followed by a deterioration in the quality of vision, so go for the procedure with a loved one to help you return home safely. The doctor will order a follow-up visit after the procedure, during which he will check the pressure and visual acuity. This can take place the day after vitreolysis procedure.
Is it possible to completely remove the opacities from the eye?
The aim of vitreolysis treatment is to maximise the reduction of opacities in the eye in a safe manner. The doctor will recommend the number of treatments after a thorough consultation and viewing of the areas in the eye affected by the opacities. Each will be followed by a consultation to observe the improvement. Sometimes, 1-2 treatments are enough, but there are also cases where more than 3 treatments are necessary. This all depends on the turbidity and its shape.
Laser treatment of glaucoma
Glaucoma is a group of diseases leading to damage to the optic nerve, often accompanied by increased intraocular pressure. In addition to pharmacology and surgery, laser therapy is also used to treat glaucoma. Different types of lasers are used. Laser therapy reduces the ocular pressure that occurs and slows the damage to the optic nerve.
Laser therapy is used in the treatment of open-angle glaucoma and angle-closure glaucoma. An open angle occurs when the orifices of the trabecular meshwork are obstructed, and a closed angle occurs when the cornea is in contact with the iris and blocks the outflow of the aqueous humour.
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