Pan-Retinal Photocoagulation (PRP)
Diabetic retinopathy does not usually impair sight until the development of long-term complications, including proliferative retinopathy, a condition in which abnormal new blood vessels grow, and may rupture and bleed inside the eye. When this advanced stage of retinopathy occurs, pan-retinal photocoagulation is usually recommended.
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Pan Retinal Photocoagulation (PRP) causes abnormal blood vessels on the retina to shrink |
During this procedure, the laser is used to destroy all of the dead areas of retina where blood vessels have been closed. When these areas are treated with the laser, the retina stops manufacturing new blood vessels, and those that are already present tend to decrease or disappear. As these abnomal vessels disappear, the risk of vitreous hemorrhage and retinal detachment is reduced.
If there is leakage in the macula (Macular Edema), the central area of the retina where sharp vision takes place, Focal Macular Laser applications can also treat the specific areas in the central vision that are leaking. This treatment is very different from PRP. The power is much less, and fewer spots are needed. When both proliferative retinopathy and macular edema are present, and both focal macular laser and PRP are needed, the focal laser is usually done first when possible, and the PRP several weeks later.
The goal of pan-retinal photocoagulation (PRP) is to prevent the development of new vessels over the retina and elsewhere, not to regain lost vision.
Pan-retinal photocoagulation is for those:
- who have been diagnosed with proliferative retinopathy
- whose doctor has determined that pan-retinal photocoagulation is the appropriate treatment for their condition
What to expect on procedure day:
Your treatment will be performed in a specially equipped laser room. It does not require a surgery center. It is can be performed with or without anesthesia, although many patients are more comfortable with a local anesthetic.
Before your procedure begins, an special lens will be placed between your eyelids to focus the laser beam and to keep you from blinking. Next, your doctor will begin laser treatment with an argon laser. The laser treats the peripheral (outside) and middle portions of your retina. PRP does not treat the central or macular region of the retina.
The initial session usually consists of approximately 500-1000 or more spots of laser per eye, but multiple sessions may be needed to cause the abnormal vessels to shrink away.
Your vision will be poor immediately after the treatment, but will usually recover to the pre-treatment level over time. You should plan to have someone drive you home, and you should relax for the rest of the day. Most patients resume activities within a few days. Regular follow-up visits are required.
Expectations:
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. After treatment, vision may decrease due to swelling of the retina (which is usually temporary) or scarring of the retina, which is uncommon, but may be permanent. Thus, vision 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 and some side 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 be permanent.
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.
If you and your doctor decide that pan-retinal photocoagulation is an option for you, you will be given additional information about the procedure that will allow you to make an informed decision about whether to proceed. Be sure you have all your questions answered to your satisfaction.
If you would like more information about this procedure you can make an appointment or contact the office for additional information.
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