After the invention of the laser (light amplification by stimulated emission of radiation) in the early 1960s, its application to the eye quickly found its way into the treatment of various eye diseases.
The Nymphenburger Höfe Eye Center in Munich has all the common laser eye systems for the treatment of retinal defects, retinal diseases in diabetes or vascular occlusions, glaucoma, among others.
Laser treatment is almost always a completely painless treatment; local anesthesia is only necessary in exceptional cases.
If the vitreous of the eye lifts (detaches) from its contact surface with the retina due to structural changes in the course of life, there may be cracks and holes in the retina (retinal foramen) where the vitreous is still connected to the retina.
Only symptoms such as flashes of light or black particles (“Floaters or soot rain”) that are perceived in the visual field indicate the risk of damage and are signals that should be taken seriously. In some cases, the patient’s eyesight also decreases. If you find these signs on your own, please consult an ophthalmologist in the next few days.
Retinal holes can be the starting point for retinal detachment. To prevent retinal detachment, laser coagulation, treatment with the argon laser, is carried out. Here the retina is fixed along the edge of the foramen with the laser to the choroid below. The hole closes to the outside and the retina can no longer detach.
If the laser treatment is no longer possible due to the size of the crack or due to the location of the crack, such cracks can often still be treated with a cold treatment that is carried out under local anesthesia.
Changes in the retina can occur with diabetes, and the risk of these changes increases the poorer the metabolism. If changes have already occurred, it is often necessary to prevent the progression with laser treatment of the retina. Vascular proliferation on the retina, bleeding in the vitreous cavity and edema formation on the macula are often the reason for laser treatment.
Which type of laser treatment is used depends on the underlying disease.
Some methods are described below as examples:
Panretinal means: “the entire retina”. With diabetes, there is a lack of oxygen in the retina due to poorer blood circulation. This lack of oxygen stimulates the growth of pathological blood vessels, from which bleeding can occur into the inside of the eye. Laser treatment of around a thousand to two thousand tiny places on the retina reduces the oxygen requirement of the affected areas and the stimulus for blood vessel growth is reduced. The capacities that have been freed thus benefit the rest of the retina.
A similar principle is based on the treatment of retinal vascular occlusions.
Focal laser photocoagulation
Leaky blood vessels can cause macular edema. In these situations, focal laser photocoagulation, which is limited to one location on the retina, can often stabilize the eyesight that is still present and contain the edema through scarring.
The tissue-protecting, subliminal laser allows treatment on the macula while avoiding thermal scarring. The extremely short micro-pulses enable a so-called “subthreshold” treatment in which the retina is not coagulated but the tissue is kept intact. The micro-pulse mode can be used to treat many diseases such as diabetic macular edema (DME) or retinopathia centralis serosa (RCS).
In addition to laser therapy, depending on the disease and its course, there is also the possibility of intravitreal medication or vitrectomy.