Panretinal photocoagulation (PRP) is a type of laser treatment for the eye. The procedure is performed on an outpatient basis (you will not need to stay overnight). This procedure may be appropriate for diabetic retinopathy and central retinal vein occlusion. Diabetic retinopathy (DR) has many stages, but the stage that requires treatment with panretinal photocoagulation is when abnormal new blood vessels form due to lack of blood flow to the eye, trigger cells to eventually create new blood vessels. These new blood vessels are fragile and can easily tear, causing bleeding in the eye. Furthermore, they can create adhesions that may dislodge the retina and lead to blindness. Central retinal vein occlusion (CRVO) may be mild or severe. Mild cases do not require treatment and the condition is monitored because it may progress in the future. If severe, central retinal vein occlusion creates new blood vessels in the retina and pupil, leading to bleeding in the eye.
Panretinal photocoagulation aims to prevent progression of disease.
-Panretinal photocoagulation reduces the blocked blood vessels and prevents the growth of new, abnormal blood vessels, and helps eliminate abnormal blood vessels. Panretinal photocoagulation is necessary to prevent progression of disease and to prevent complications that can ultimately lead to blindness.
-Panretinal photocoagulation does not improve vision in most patients, but may do so in certain ones
The ophthalmologist will carefully inspect your retina to assess the size and location of the problem. You will be given eye drops to dilate your pupil. A nurse will assess the pupil dilation and provide instructions as necessary. You will be given a local anesthetic eye drop (0.5% tetracaine) for the affected eye. While the procedure is performed, it is recommended that you do not move your eyes. Please focus on the spot specified by your doctor and keep your eye as still as possible. The procedure takes 15-30 minutes, depending on the severity of the condition.
Since the procedure requires that the pupil is dilated, which causes blurry vision for 4-6 hours, you should not drive yourself home. It is recommended that a friend or family member accompany you to the hospital. If you are by yourself, you will need to wait at the hospital until your vision is back to normal.
After pupil dilation, you will not be able to see clearly as more light will enter your eye than normal. This should last about 4-6 hours. The nurse will recommend that you are careful to avoid falling. You may feel some tightness in your eye. Pain medication can relieve discomfort. Please do not rub your eyes. After the procedure, you may resume normal activities and wash your face as usual. Please use eye drops in strict accordance with the doctor’s instructions.
Generally, the ophthalmologist will carry out the treatment in 2-3 sessions as administering a large amount of laser in one session can cause swelling in the eye, worsening blurry vision and increasing eye pressure. During the procedure, if you move your eyes, the ophthalmologist may damage the part of your eye where vision is still clear, which can then reduce your central vision. Please follow the doctor’s instructions carefully during the panretinal photocoagulation. Panretinal photocoagulation may cause vision to narrow and reduce vision in low light. However, without the treatment, vision may be lost completely and permanently. Patients with existing health conditions, such as seizures, may experience a seizure during the procedure. Thus, it is important to let the doctor and nurse know of any existing health problems you have so the appropriate preventive measures may be put in place. See Your Doctor Please see your doctor immediately if you experience: Worsening blurry vision. Severe eye pain or persistent pain not controlled with pain medication. Red eye or excessive discharge from the eye. Follow-up The doctor will schedule a follow-up appointment when appropriate.
What is diabetic retinopathy and what are its causes?
Diabetes is a disease that affects blood vessels throughout the body, particularly vessels in the kidneys and eyes. When the blood vessels in the eyes are affected, this is called diabetic retinopathy. Everyone who has diabetes is at risk for developing diabetic retinopathy, but not everyone develops it. Changes in blood sugar levels increase the risk. Generally, diabetics don’t develop diabetic retinopathy until they’ve had diabetes for at least 10 years.
What are the travel restrictions?
There are no limitations for travel before or after the procedure.
What is the likelihood of success?
The success of the procedure depends on a number of factors. Please discuss the likelihood of success with your doctor before the procedure.
What if this procedure is not performed?
Create adhesions that may dislodge the retina and lead to blindness.
What should I expect after treatment?
The goal of pan-retinal photocoagulation is to prevent the development of new vessels over the retina and elsewhere, not to regain lost vision. There is no improvement in vision after the laser treatment. Vision may decrease due to edema/swelling of the retina, after the laser treatment. It may improve to its previous level in two to three weeks or may remain permanently deteriorated. Recurrences of proliferative retinopathy may occur even after an initial satisfactory response to treatment. This procedure sacrifices peripheral vision in order to save as much of the central vision as possible and to save the eye itself. Night vision will be diminished. After pan-retinal photocoagulation, blurred vision is very common. Usually, this blur goes away, but in a small number of patients some blur will continue forever. Serious complications with pan-retinal photocoagulation are extremely rare, but like any surgical procedure, it does have risks. These risks can be minimized by going to a specialist experienced in pan-retinal photocoagulation. You will need someone to drive you home from the doctor's office or clinic after the procedure. Eyedrops are used to widen (dilate) your pupils before the procedure. And your eyes will remain dilated for several hours afterward. Wear sunglasses to keep bright light out of your eyes while they are still dilated. Your vision may be blurry and your eye may hurt a little for a day or two after the treatment. Be sure to keep all follow-up appointments with your doctor and report any changes in vision that you notice. Follow-up treatment can make a big difference in keeping your vision for the long term.