Our Advanced Retina Treatments Can Protect Your Vision
Pacific Retina Specialists provides laser retina surgery and vitrectomy to treat damage to the retina caused by diabetes and other conditions. Dr. David Parks has a national reputation for his skill and experience, as well as his caring, gentle treatment of patients.
- Laser Surgery
- Intraocular Medication Injections
- Retinal Angiography
To learn more about how our retina treatments can protect your vision, contact our practice serving Beverly Hills, Lancaster, and Tamuning.
In preparation for laser eye surgery, you will receive eye drops to dilate the pupil and to numb the eye. We may also use a nerve block injection to numb the entire eye area.
The procedure is performed in a sitting position. The laser is aimed through a special lens Dr. Parks holds in front of the eye. There may be some green flashes visible and a slight feeling of stinging and pressure as the beam of laser light strikes the eye.
As soon as laser retina surgery is finished, the patient if free to leave. Because the dilation will last a few hours after the procedure, vision will remain blurry; the patient should arrange to be driven home. Sunglasses are also recommended to deal with the extra light admitted by dilated pupils. Discomfort is rare, but can usually be treated with acetaminophen.
Laser Surgery for Diabetic Macular Edema and Proliferative Retinopathy
A procedure known as focal laser treatment is used for cases of macular edema. A beam of high-energy laser light is used to seal leaking blood vessels. This will not improve vision, but stabilize it. Since macular edema is a progressive condition, it can only be slowed, not cured, and repeated treatments are required to control new outbreaks.
The laser is used to destroy abnormal blood vessels that form in the back of the eye in cases of advanced diabetic retinopathy. Since hundreds of small flashes are required to shrink the blood vessels, there will be some loss of peripheral vision, and possibly a reduction of color vision and night vision.
Since there is a risk of new outbreaks, repeated treatments may be required to protect vision.
Intraocular Medication Injections
Intraocular medications are an effective way of medically modulating abnormal retinal blood vessels that may be leaking fluid. Depending on the retinal problem, Dr. Parks may recommend injections of the steroid medication triamcinolone to reduce retinal swelling, or anti–vascular endothelial growth factor medications such as Macugen® (pegaptanib) or Avastin® (befacizumab) to stop the growth of abnormal blood vessels that occur in age related macular degeneration, diabetic retinopathy, and other retinal diseases. Intraocular steroid injections are an effective way of medically modulating abnormal retinal blood vessels that may be leaking fluid. The injections are performed in the office after the eye’s surface is made numb with anesthetic. Patients rarely feel any discomfort with the procedure. There is some transient blurring of the vision after the injection that subsides within a few days.
In cases of sufficient blood or scar tissue in the vitreous to blur vision, a vitrectomy may be performed at our ophthalmology centers. The cloudy vitreous is removed and its volume replaced with a mild saline solution similar to that which the body would naturally produce over time to replace the vitreous.
Vitrectomy is often performed with local anesthesia and sedation. You will not be completely asleep during the operation, but you will be very relaxed and feel no pain. Dr. Parks makes three tiny incisions in the sclera, or the white of the eye. Next, three small instruments are used through the incisions to remove the vitreous, insert the salt solution into the eye, and provide light for Dr. Parks to see the critical structures inside the eye.
You may be able to return home soon after the vitrectomy, unless you live a long distance from our clinics, in which case you may be asked to spend the night at a nearby hospital. A protective patch may be appropriate for a day or two, and, since your eye will be sensitive, eye drops may be used to reduce irritation and protect against infection.
What Research is Being Done?
Many government organizations and charities are conducting and supporting laboratory and clinical studies to learn more about the cause of diabetic retinopathy, in hopes of finding better ways to detect, treat, and prevent vision loss in people with diabetes.
One approach is to stop enzyme activity that has been shown to cause diabetic retinopathy. To that end, researchers are working to develop new drug therapy to help control progression and reduce the need for laser surgery.
What Can You Do to Protect Your Vision?
Pacific Retina Specialists urges everyone with diabetes to have an annual dilated-pupil eye examination. For those who have developed serious retinopathy, Dr. Parks will suggest a schedule of more frequent examinations.
According to a recent study by the Diabetes Control and Complications Trial (DCCT), effective control of blood sugar levels slows the onset and progression of retinopathy, as well as reducing the need for laser surgery for severe retinopathy. Study participants who kept their blood sugar levels as close to normal as possible had much less eye, kidney, and nerve disease. Elderly patients, children under 13, and patients with heart disease should consult a doctor for guidance in blood sugar control for retinopathy, since there are other considerations applicable to them.
For more information about diabetic retinopathy or diabetes, you may wish to contact:
- American Academy of Ophthalmology
- American Diabetes Association
- Juvenile Diabetes Foundation International
- National Diabetes Information Clearinghouse of the National Institutes of Health
- Prevent Blindness America
To ensure the best result from retina surgery, our offices are equipped to provide comprehensive testing. Dr. Parks will use the results of these tests, as well as his extensive training and experience, to plan the treatment most appropriate to each patient.
Our testing procedures include:
Fluorescein angiography involves the injection of fluorescein, a yellow dye derived from vegetables, into the hand or arm. A series of photographs are then taken of the retina. The results are used to help diagnose certain retinal disorders. In some cases, such as diabetic retinopathy or macular degeneration, the angiogram allows Dr. Parks to determine the best way to treat the condition, such as with a laser surgery, medications, or traditional surgery. There are minimal side effects to fluorescein angiography, and we will discuss these in detail prior to your procedure. The study takes about 15 minutes, and we use digital imaging systems that allow for instantaneous results. In addition, patients may drive home or return to work following the procedure.
Indocyanine Green (ICG) Angiography
ICG angiography is a more specific angiogram used to help diagnose the presence of abnormal vessels in the deeper layers of the retina and subretinal tissues. This is particularly useful in certain types of macular degeneration.
We also offer a full range of tests to detect diabetic retinopathy, macular holes, and macular degeneration.