Laser coagulation
| Laser coagulation | |
|---|---|
| Intervention | |
| MeSH | D017075 |
Laser coagulation or laser photocoagulation surgery is used to treat a number of eye diseases and has become widely used in recent decades. During the procedure, a laser is used to finely cauterize ocular blood vessels to attempt to bring about various therapeutic benefits.
The procedure is used mostly to close blood vessels in the eye, in certain kinds of diabetic retinopathy; it is no longer used in age related macular degeneration in favor of anti-VEGF drugs.
The American Academy of Ophthalmology practice guidelines recommend laser coagulation for people who have both mild to moderate nonproliferative diabetic retinopathy (NPDR) and clinically significant macular edema outside the fovea; treatment with anti-VEGF drugs is better than laser coagulation for clinically significant macular edema in the fovea. For people with severe NPDR and no macular edema, the AAO recommends laser photocoagulation for the whole retina; when there is macular edema, the laser coagulation focused on major lesions is recommended. As of 2016, while there is preliminary evidence that anti-VEGF drugs may be useful for proliferative diabetic retinopathy, laser coagulation across the whole retina is still preferred in the AAO recommendations, as there is long-term follow up data for laser treatment but not for drug treatment.
Anti-VEGF drugs are potentially superior to laser coagulation for diabetic macular edema; some specialists are using the drugs over laser coagulation.
The American Academy of Ophthalmology practice guidelines do not recommend laser coagulation therapy for macular degeneration, but said that it may be useful in people with new blood vessels in the choroid outside of the fovea who don't respond to treatment with anti-VEGF drugs.
Argon, krypton, dye and diode lasers have been used with varying levels of energy have been used to try to prevent age-related macular degeneration by eliminating drusen. A Cochrane review published in 2015 found that while laser treatment reduces drusen, there is no difference from placebo at 2 years with respect to preventing vision loss.
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