Laser photocoagulation is a type of eye surgery. It’s not a common way to treat wet age-related macular degeneration (AMD), but it might be the right choice for some people.
Talk to your doctor about all your treatment options for wet AMD. They’ll let you know if laser surgery could help preserve your sight.
What Is Laser Photocoagulation and Who Gets It?
This is a type of “hot” laser treatment, so-called because the laser generates heat during the procedure. During the surgery, the doctor uses an intense laser beam to burn and seal abnormal blood vessels in your eye. The goal of laser photocoagulation for wet AMD is to stop blood and fluid from continuously leaking into your retina.
Laser photocoagulation is an older way to treat wet AMD. Newer drug treatments come with fewer side effects and work well for most people. That's why laser photocoagulation isn’t used very often anymore.
But your doctor might suggest this type of surgery in certain situations. Laser photocoagulation might be an option for you if:
- Your abnormal blood vessels are in tight, well-defined clusters.
- The blood vessels are far away from the center of your macula.
- Your vision loss came on fast.
- You don’t respond to other treatments.
Right now, the first-choice treatment for wet AMD is drugs that target proteins involved in forming new blood vessels in your eyes. Most block a protein called vascular endothelial growth factor (VEGF). Some also target the angiopoietin-2 (Ang-2) protein.
You generally get this medicine through shots in your eye every few weeks to months. Your doctor might suggest this drug treatment alongside laser photocoagulation to slow the growth of abnormal blood vessels.
Benefits of Laser Photocoagulation
Wet AMD is a fast-moving form of macular degeneration. If it's left untreated, you could lose sight in a matter of days or weeks. With laser photocoagulation, your doctor can try to seal leaky blood vessels quickly. Prompt treatment lowers your odds of serious vision loss.
Laser photocoagulation usually doesn’t bring back vision you’ve already lost due to wet AMD. But it may slow damage caused by the disease. This may help you keep your central vision for longer.
Risks of Laser Photocoagulation
During surgery, the laser burns part of your macula. This results in a scar that stops the blood vessels from leaking. But it can also affect healthy cells in your eye and result in added vision loss. You could end up with a permanent blind spot, but you may be able to get used to it.
Other risks of laser photocoagulation include:
- Extra eye bleeding
- Retina damage that happens right away or years later
- Vision loss that’s worse than before you got treatment
There’s also a chance the treated blood vessels will leak again within 2 years. Studies show this happens to about 50%-60% of people with wet AMD who are treated with laser photocoagulation. You may need repeat surgeries if this happens to you.
What to Expect from Surgery
Ask your doctor to go over the procedure ahead of time. Here are some things to expect before, during, and after laser photocoagulation:
To prepare for surgery. Talk to your doctor about any regular medications you take, including any dietary supplements. You might need to stop certain drugs or vitamins before your procedure. You’ll also want to go to the hospital free of any eye makeup.
Before the day of the procedure, here are some questions to ask your doctor:
- Can I get a pre-surgery drug to help me relax?
- Will someone need to drive me home?
- What will laser surgery feel like?
- When can I get back to work or other daily activities?
During surgery. You’ll get eyedrops to dilate your pupil and numb the area. Some people say the procedure can be uncomfortable or painful. You may get extra numbing shots in your eye to lessen the chances you’ll feel any sting from the laser beam.
The treatment itself generally takes less than 30 minutes. The doctor will:
- Sit you in a chair
- Put a special contact lens in your affected eye
- Use a tool to focus the laser beam through the contact
- Seal off the abnormal blood vessels with the laser
Recovery. You’ll be able to go home after the procedure, but a friend or family member should stay with you. Expect your vision to be blurry for a day or so after surgery. This is normal and should go away on its own.
You might need to wear an eyepatch or sunglasses for several hours or until the next day. Your eye may hurt a little bit after surgery. But you should be able to manage the pain with over-the-counter painkillers.
Tell your doctor right away if you have signs of infection, including:
- Eye redness
- Swelling
- Serious pain
You may not know for several weeks whether the surgery worked, so keep up with your scheduled follow-up visits. Plus, your doctor will want to check for any problems related to the surgery, including new vision loss.
How Much Does Surgery Cost?
The price of laser photocoagulation varies. Some studies show that the Medicare allowable costs (what Medicare will pay for medical services) for this type of procedure may range from $349 to $805 per session.
How much you’ll have to pay depends on the type of health insurance coverage you have and where you get the surgery. Call your insurance provider before you have laser photocoagulation. They’ll go over all of your out-of-pocket costs, if any.
Show Sources
Photo Credit: Wavebreakmedia / Getty Images
SOURCES:
Tufts Medical Center: “Macular Degeneration: Laser Surgery.”
Kellogg Eye Center (University of Michigan Health): “Age-related Macular Degeneration (AMD or ARMD).”
Johns Hopkins Medicine: “Laser Photocoagulation for Age-Related Macular Degeneration.”
Mayo Clinic: “Wet macular degeneration.”
WillsEye Hospital: “Wet AMD.”
American Macular Degeneration Foundation: “Macular Degeneration Treatments.”
Deutsches Arzteblatt International: “The Treatment of Wet Age-Related Macular Degeneration.”
Clinical Ophthalmology: “Pain and accuracy of focal laser treatment for diabetic macular edema using a retinal navigated laser (Navilas).”
Beth Israel Lahey Health Winchester Hospital: “Surgical Procedures for Macular Degeneration.”
Ophthalmology: “Cost Evaluation of Early Vitrectomy versus Panretinal Photocoagulation and Intravitreal Ranibizumab for Proliferative Diabetic Retinopathy.”
