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There are two treatments for diabetic retinopathy. They are very
effective in reducing vision loss from this disease. In fact, even people
with advanced retinopathy have a 90 percent chance of keeping their vision
when they get treatment before the retina is severely damaged.
These two treatments are laser surgery and vitrectomy.
It is important to note that although these treatments are very successful,
they do not cure diabetic retinopathy.
Laser Surgery
Laser surgery is performed in a doctor's office or eye clinic. Before
the surgery, your ophthalmologist will: (1) dilate your pupil and (2)
apply drops to numb the eye. In some cases, the doctor also may numb the
area behind the eye to prevent any discomfort.
The lights in the office will be dim. As you sit facing the laser machine,
your doctor will hold a special lens to your eye. During the procedure,
you may see flashes of light. These flashes may eventually create a stinging
sensation that makes you feel a little uncomfortable.
You may leave the office once the treatment is done, but you will need
someone to drive you home. Because your pupils will remain dilated for
a few hours, you also should bring a pair of sunglasses.
For the rest of the day, your vision will probably be a little blurry.
If your eye hurts a bit, your eye care professional can suggest a way
to control this.
Doctors will perform laser surgery to treat severe macular edema
and proliferative retinopathy.
Macular Edema: Timely laser surgery can reduce vision
loss from macular edema by half. But you may need to have laser surgery
more than once to control the leaking fluid.
During the surgery, your doctor will aim a high-energy beam of light
directly onto the damaged blood vessels. This is called focal laser
treatment. This seals the vessels and stops them from leaking. Generally,
laser surgery is used to stabilize vision, not necessarily to improve
it.
Proliferative Retinopathy: In treating advanced diabetic
retinopathy, doctors use the laser to destroy the abnormal blood vessels
that form at the back of the eye. Rather than focus the light on a single
spot, your eye care professional will make hundreds of small laser burns
away from the center of the retina. This is called scatter laser
treatment. The treatment shrinks the abnormal blood vessels. You
will lose some of your side vision after this surgery to save the rest
of your sight. Laser surgery may also slightly reduce your color and
night vision.
Once you have proliferative retinopathy, you will always be at risk
for new bleeding. This means you may need treatment more than once to
protect your sight.
Vitrectomy
Instead of laser surgery, you may need an eye operation called a vitrectomy
to restore your sight. A vitrectomy is performed if you have a lot of
blood in the vitreous. It involves removing the cloudy vitreous and replacing
it with a salt solution. Because the vitreous is mostly water, you will
notice no change between the salt solution and the normal vitreous.
Studies show that people who have a vitrectomy soon after a large hemorrhage
are more likely to protect their vision than someone who waits to have
the operation.
Early vitrectomy is especially effective in people with insulin-dependent
diabetes, who may be at greater risk of blindness from a hemorrhage into
the eye.
Vitrectomy is often done under local anesthesia. This means that you
will be awake during the operation. The doctor makes a tiny incision in
the sclera, or white of the eye. Next, a small instrument is placed into
the eye. It removes the vitreous and inserts the salt solution into the
eye.
You may be able to return home soon after the vitrectomy. Or, you may
be asked to stay in the hospital overnight. Your eye will be red and sensitive.
After the operation, you will need to wear an eyepatch for a few days
or weeks to protect the eye. You will also need to use medicated eye drops
to protect against infection.
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