What is laser surgery for macular degeneration?

Macular degeneration is a worsening of the retina near the optic nerve at the back of the eye. The retina is the area of the eye that sees detail at the center of the field of vision. There are two types of macular degeneration: wet and dry. The dry type is more common and cannot be treated. The wet type is caused by abnormal blood vessels that form under the retina and leak fluid or blood under and into the macula. If discovered early enough, the doctor can destroy these abnormal blood vessels by laser treatment.

Macular degeneration usually develops gradually and is painless. In advanced cases central vision disappears, but the peripheral or outer part of the field of vision remains.

When is it used?

Sometimes wet macular degeneration can be treated by laser surgery. During the procedure, the doctor tries to slow down the loss of vision by destroying the leaking vessels.

In some cases an alternative is to have abnormal blood vessels surgically removed. Another alternative is to choose not to have treatment, recognizing the risks of your condition. You should ask your doctor about these choices.

How do I prepare for laser surgery?

Follow the doctor's instructions. Plan for care and recovery after the operation. The eye may be patched for several hours, so you will need to arrange for transportation.

What happens during the procedure?

The pupil of the eye is dilated with eyedrops and a local anesthetic is often used. While sitting at the microscope, the doctor locates the leaking vessels, places a contact lens on the eye, and then uses a laser to seal the leak(s).

What happens after the procedure?

When you feel comfortable and secure, you may leave the recovery area. Someone should accompany you home. The eye may be patched for several hours. Avoid heavy work for the next day or two. You can ride in a car, stoop over to put on shoes, and resume light work.

You should ask your doctor what other steps you should take and when you should come back for a checkup.

What are the benefits of this procedure?

The loss of central vision may be slowed down.

What are the risks associated with this procedure?

• The laser may further damage the macula, resulting in some additional loss of vision. This is especially true if the leaking blood vessels are very close to or in the very center of the macula.

• There is a risk of a reaction to the eyedrops or anesthetic.

You should ask your doctor how these risks apply to you.

When should I call the doctor?

It is not unusual for the vision of the eye to be more blurred for a few days.

Call the doctor immediately if:

• You become nauseated or dizzy.

• You develop pain in your eye.

• The vision suddenly becomes worse.