Laser surgery has been one of the great advances in treating eye diseases. The success of the laser depends on the type of eye disorder.
In most situations, laser surgery helps prevent further loss of sight, but will not provide great improvement in vision. In a few situations, vision may be restored to normal.
Your ophthalmologist will discuss the risks and benefits that laser treatment can offer you.
How does the laser work?
There are two different ways that lasers are used to treat eye diseases.
Thermal lasers: The light is converted to heat when it reaches the eye. The heat is used to:
- Seal blood vessels (veins and arteries) that are bleeding or leaking fluids
- Destroy abnormal tissue, such as a tumor
- Bond the retina to the back of the eye
- Open the eye's filtration system to treat glaucoma
- Create an opening in the iris for treatment of narrow angle glaucoma
Photodisruptive lasers: The light cuts or sculpts the tissue, similar to a knife. The beam of light is used to:
- Cut thin membranes inside the eye that are blocking vision
- Change the shape of the eye's surface
Advantages of ophthalmic lasers
Laser surgery of the eye has several advantages:
- There is no risk of infection from the laser light.
- Laser surgery can be performed in an outpatient setting, without an overnight hospital stay.
- The surgeon has great precision and control.
Diseases that are treated
Diseases of the retina
Retinal tears or holes: The retina is the inner layer of the eye that senses light and helps you to see. If the retina tears, it can separate from the back wall of the eye. This is called a detached retina, and it can cause you to lose sight.
Most retinal tears can be treated with the argon or krypton laser, if they are found before the retina detaches. The laser helps bond the retina to the wall of the eye, preventing a retinal detachment.
If retinal detachment has already occurred, the laser may be used to surgically repair the detachment.
Diabetic retinopathy: Eye disease from diabetes is a major cause of vision loss. Diabetes can cause blood vessels in the retina to grow abnormally. The vessels can leak fluid (macular edema) or bleed inside the eye.
Laser surgery to treat diabetic retinopathy:
- Seals leaking blood vessels to reduce macular edema, helping to prevent further vision loss
- Slows or stops growth of abnormal blood vessels, decreasing the chance of bleeding in the eye
Macular degeneration: The macula is the small, central area of the retina that allows us to see fine details clearly. Macular degeneration affects your central or reading vision.
Most people have "dry" macular degeneration, which cannot be helped by laser surgery.
A few people have "wet" macular degeneration. Abnormal blood vessels cause bleeding and scarring of the macula. In certain cases, these people may be treated with the argon or krypton laser. The laser seals the blood vessels to prevent further damage.
There are other retina problems that can be treated with the laser, including:
- Retinal vein occlusions
- Central serous retinopathy
- Some tumors of the eye
After cataract surgery
After a cataract has been removed, the capsule of the lens sometimes becomes cloudy. The neodymium-YAG laser can open up this cloudy membrane and restore clear vision. The laser is not used to remove cataracts.
Glaucoma is a disease of the optic nerve, which sends images from the eye to our brain and allows us to see. Glaucoma affects at least two out of every 100 older Americans.
Glaucoma damages the optic nerve, usually because the fluid pressure inside the eye is too high. Loss of vision from glaucoma can often be prevented if your ophthalmologist discovers the disease before much damage occurs to the optic nerve.
Glaucoma must be detected early if treatment is to be successful.
Eye drops or pills are the usual way to treat glaucoma. If they do not control the pressure within the eye, laser surgery may be used to create a tiny opening, allowing the fluid to drain and release pressure.
For more information about DMC Sinai-Grace Hospital’s ophthalmology services or to make an appointment, call 313-966-4800.