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What is Laser Photocoagulation?

There are a variety of treatments for macular degeneration, depending on the type of macular degeneration you have. In age-related macular degeneration (AMD), there are two subtypes: dry and wet. In dry AMD, the light-sensitive cells in the macula that send images to the brain, along with supporting tissue under the macula, slowly break down, causing vision loss.1 In wet AMD, abnormal blood vessels grow under the retina. They can leak and bleed, damaging the macula and causing vision loss.1 This abnormal blood vessel growth is also seen in myopic macular degeneration or MMD.

What is laser photocoagulation?

Laser photocoagulation is a type of laser treatment for select patients with wet AMD. If you have abnormal blood vessels scattered in the macula, this procedure is less likely to be for you; it’s more geared toward those who have abnormal blood vessels clustered together so the laser can be concentrated in one location. In this procedure, after dilation and numbing eye drops are administered, a beam of light creates small burns in the affected sections of the macula, sealing off any underlying abnormal blood vessels.2 This reduces the risk of further damage to the macula by preventing those abnormal blood vessels from leaking or bleeding. This surgery will not restore any vision previously lost from AMD but can slow the progression of further vision loss.2

While this treatment used to be used for MMD, it is not used as much anymore. The benefits for MMD have not been sustained, and this is not a preferred treatment for that kind of macular degeneration.3

What does laser photocoagulation entail?

Laser photocoagulation is done as an outpatient procedure in your eye doctor’s office. Before the procedure, ask your doctor if you have to prepare at all by not taking any medications, or if there’s anything you should do or any exams or tests that need to be done prior to the procedure.

Once you’re at the office, you’ll get drops to dilate your pupil, as well as drops to numb your eye. A special contact lens will be placed on the affected eye, to help focus the laser onto the retina.2 The doctor then uses the laser to seal off the abnormal blood vessels under the macula.

After the procedure, your eye might be covered temporarily; this is normal. You’ll be able to go home afterward, but you should have a driver since you may have light sensitivity or blurred vision.

After laser photocoagulation

Post-procedure, your eye might feel sore temporarily; ask your doctor if over-the-counter pain medications are appropriate for you. Your doctor might ask you to wear an eyepatch or dark glasses to help reduce light sensitivity for a few days. Talk with your doctor about when you’ll be able to resume your regular activities.

See your eye doctor regularly for follow-up visits to ensure that your eye heals properly and to monitor for any complications. If you experience anything out of the ordinary, especially swelling, pain, or worsening vision, call your doctor.

Considerations

Your vision will be blurry shortly after the procedure; this is normal and resolves on its own. The surgery may cause a new area of vision loss or blind spot due to parts of the macula being burned, but overall the procedure reduces the risk of vision loss from progression of wet AMD.2

As with any medical procedure, there are risks, including2:

  • Accidental lasering of the fovea (central area of the macula), causing a significant blind spot
  • Bleeding into the eye
  • Damage to the retina from the laser scar; this might occur years later
  • Light sensitivity
  • Temporary eye soreness
  • Possibility that abnormal blood vessels may grow back

Other risks may depend on your specific circumstances. Talk with your eye doctor about what risks may apply to you regarding this procedure.

Is laser photocoagulation appropriate for you?

If you have wet AMD, talk with your eye doctor about your treatment options and whether you might be a candidate for laser photocoagulation. While it carries significant benefits, like any medical procedure, it also carries some risks. Knowing the full picture of any procedure can help you make an informed decision that’s right for you.

Written by Jaime R. Herndon | Reviewed September 2019
  1. National Institutes of Health: National Eye Institute. Facts About Age-Related Macular Degeneration. 2015. https://nei.nih.gov/health/maculardegen/armd_facts. Accessed November 16, 2018.
  2. Johns Hopkins Medicine. Laser Photocoagulation for Age-Related Macular Degeneration. n.d. https://www.hopkinsmedicine.org/healthlibrary/test_procedures/other/laser_photocoagulation_for_age-related_macular_degeneration_135,342. Accessed November 16, 2018.
  3. Raecker M, Park D-W, Lauer A. Diagnosis and Treatment of CNV in Myopic Macular Degeneration. American Academy of Ophthalmology. 2015. https://www.aao.org/eyenet/article/diagnosis-treatment-of-cnv-in-myopic-macular-degen. Accessed February 4, 2019.