Laser Surgery for Age-Related Macular Degeneration

What is laser surgery for age-related macular degeneration?

Laser surgery is a treatment that can sometimes be used to slow down vision loss caused by the wet form of age-related macular degeneration (AMD). AMD is a disease that damages the macula in the eye. The retina is the back part of the eye and the macula is in the center of the retina. The macula is responsible for helping you see fine details in the center of your vision. The loss of central vision can make it difficult to read, drive, or recognize faces.

There are 2 types of AMD: dry and wet. In the dry form, the light-sensitive cells in the macula gradually break down and central vision is slowly lost. Wet AMD occurs when new, fragile blood vessels grow under the macula. These vessels leak blood and fluid and cause scarring. Vision loss from this damage can happen quickly. The most common treatment for wet AMD is injection of medicine into the eye. Sometimes these injections are not effective or do not last long enough. In these cases, if these blood vessels are not located under the very center of the macula, laser treatment can be used to try to seal the blood vessels, which can decrease the chance of vision loss.

If your blood vessels are growing under the center or very close to the center of your macula, your eye surgeon may recommend cold laser treatment (photodynamic therapy, or PDT), or shots of medicine that make the abnormal blood vessels shrink. The regular "hot laser" treatment destroys the nearby tissue as well as blood vessels. The cold laser may be able to destroy the new, leaky vessels without hurting the nearby normal tissue.

In some cases, not doing anything about the abnormal blood vessels may be a reasonable choice.

How do I prepare for laser surgery?

Follow the surgeon's instructions. Plan for your care and recovery after the operation. You will need to arrange for someone to drive you home.

What happens during the procedure?

Your surgeon dilates your pupil with eyedrops. Then he or she puts drops of anesthetic in your eye to numb it. Sometimes your surgeon will give you a shot around or behind the eye to numb the eye more. Then your surgeon will aim the laser at the blood vessels.

What happens after the procedure?

You can go home after the procedure, but someone should go home with you. Your vision may be poor for a few hours after the procedure. If you have received a shot, you may need to keep a patch on your eye for several hours after the laser.

If you have had PDT, your provider will tell you to avoid sunlight for a few days because the medicine you are given before the treatment with the laser makes your skin sensitive to sunlight.

Ask your provider 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 loss of vision and possibly a permanent blind spot. This is especially true if the leaking blood vessels are very close to or in the center of the macula.
• The blood vessels may come back even after a successful laser treatment.

Ask your provider how these risks apply to you.

When should I call my healthcare provider?

Call right away if your vision suddenly gets worse or you develop a new problem with your vision.