Laser Treatment for Proliferative - Explanation

belyro · #1 (**permalink**) 08-22-2007, 01:12 PM

Today I asked my retinal specialist exactly what it was that was being zapped during my laser treatments, because I've always wondered and never got a really straight answer from any source.

It's kinda complicated, but in language those of us who aren't retinal specialists can understand, he said that because my retinal tissue isn't getting enough oxygen, it sends the signal to the brain to make more blood vessels. These are the vessels that are weak and leak easily and really serve no purpose to the retina. So, he's zapping the retinal tissue in the peripheral areas and killing it. (I had always thought he was zapping something "new" that had developed because of the retinopathy, but he's actually zapping regular retinal tissue.) This means that the retina requires less oxygen, so the signals to make new blood vessels are no longer being sent to the brain. Essentially, the peripheral tissue is being sacrificed to save the tissue at the centre that is more important to my vision.

Anyway, that's the quick and dirty version, in case anyone other than me was also wondering.

shockme · #2 (**permalink**) 08-22-2007, 01:33 PM

thanks bethany! i always thought they zapped the new vessels,too....trish

RobiJo · #3 (**permalink**) 08-22-2007, 01:40 PM

Good explanation. I was told pretty much the same thing, but he also zapped some of the leaking spots to make them stop leaking. I was trying to count it up today, I think I had about 2,500 in the right eye and around 1,500 in my left.
I can't believe you can look at your screen to type. All I could do afterwards was swallow some Tylenol and sleep it off. My pupils were so big you could barely tell what color my eyes were.

I'm glad this is going well for you. You seem to be handling it very well!

belyro · #4 (**permalink**) 08-22-2007, 01:47 PM

Quote:

Originally Posted by RobiJo

I can't believe you can look at your screen to type. All I could do afterwards was swallow some Tylenol and sleep it off.

I'm glad this is going well for you. You seem to be handling it very well!

When he only does between 300 and 400 it's not too bad. I'm on painkillers, though.

I'm handling it all much better now than I was at first. There's been quite a lot of "processing" for me.

Mich · #5 (**permalink**) 08-22-2007, 02:53 PM

Hey Beth,

Glad to hear you're making progress with the zapfest. That processing does take some effort sometimes, doesn't it?
Hope the rest of your treatments go fairly effortlessly. Hugs to you, you're doing well! Mich

peej07 · #6 (**permalink**) 08-22-2007, 05:51 PM

Great to hear you are doing well. I also thought the whole zap fest was to stop the growth rather than prevent more growth.

belyro · #7 (**permalink**) 08-22-2007, 06:10 PM

Quote:

Originally Posted by peej07

Great to hear you are doing well. I also thought the whole zap fest was to stop the growth rather than prevent more growth.

I think it *may* also stop it, because once the signal stops getting sent I think the little new vessels that are already there shrivel up and go away....but I'm not sure about that. I didn't ask the optho.

xMenace · #8 (**permalink**) 08-22-2007, 06:31 PM

Quote:

Originally Posted by belyro

I think it *may* also stop it, because once the signal stops getting sent I think the little new vessels that are already there shrivel up and go away....but I'm not sure about that. I didn't ask the optho.

They usually do. If they don't, hemmhoraging and all the fun with that may follow. Catching them early is definately a bonus.

Mich · #9 (**permalink**) 08-23-2007, 08:37 AM

Thanks also Beth for the clarification on the use of the laser. I,also thought it was to destroy the new growth vessels, rather than to reduce to needed oxygen in the area. It makes sense though and explains why a bit of our peripheral vision is affected.

For further research, the "signal" is called Vascular Endothelial Growth Factor or VEGF. The other way to treat it is to inject either Lucentis or Avastin directly into the overgrowth area.

xMenace · #10 (**permalink**) 08-23-2007, 10:31 AM

Here's another excellent site. Proliferative Retinopathy

As the animations show, new blood vessel growth happens in the optic disc area. Shooting lasers into that space can be very damaging. These are very fine vessels that can barely be seen let alone hit every time with a laser. Obviously surgical removal is risky too.

noonegetsme · #11 (**permalink**) 08-23-2007, 11:29 AM

I have had so many of these zap fest I can't even remember I think I have had 25-30 separate sessions anywhere from 300-700.
I had a Vitrectomy 2 years ago.

My first zapper used a numbing shot . The retinal surgeon called in after the previous zapper said his zapper wasn't sufficient doesn't. I've found the recovery time to be much shorter without the shot any one else find this to be true?

belyro · #12 (**permalink**) 08-23-2007, 11:33 AM

Quote:

Originally Posted by noonegetsme

I have had so many of these zap fest I can't even remember I think I have had 25-30 separate sessions anywhere from 300-700.
I had a Vitrectomy 2 years ago.

My first zapper used a numbing shot . The retinal surgeon called in after the previous zapper said his zapper wasn't sufficient doesn't. I've found the recovery time to be much shorter without the shot any one else find this to be true?

I've never had the shot. I've tried to avoid it at all costs, because then I'd pass out for SURE! A needle to the eye?? No thanks!

noonegetsme · #13 (**permalink**) 08-23-2007, 12:02 PM

It was scary ...but they would usually give me valium before the came at with any needles

RobiJo · #14 (**permalink**) 08-23-2007, 12:50 PM

Quote:

Originally Posted by noonegetsme

I have had so many of these zap fest I can't even remember I think I have had 25-30 separate sessions anywhere from 300-700.
I had a Vitrectomy 2 years ago.

I'm curious--how has your vision been since your vitrectomy and is your doc concerned about the problems reoccuring???

Quote:

Originally Posted by belyro

I've never had the shot. I've tried to avoid it at all costs, because then I'd pass out for SURE! A needle to the eye?? No thanks!

I was never given a shot either, can't say I want one! The best thing about the vitrectomy is that you are knocked out and don't have to look at or focus on anything. You don't see or know what's about to happen.

xMenace · #15 (**permalink**) 08-23-2007, 01:17 PM

Quote:

Originally Posted by noonegetsme

I have had so many of these zap fest I can't even remember I think I have had 25-30 separate sessions anywhere from 300-700.

Not likely. That's at least 25*300 or 7500 blasts. I don't know what the max is, but my reading suggests the 3,000 range. This stuff can easily blend together.

Quote:

Originally Posted by noonegetsme

My first zapper used a numbing shot . The retinal surgeon called in after the previous zapper said his zapper wasn't sufficient doesn't. I've found the recovery time to be much shorter without the shot any one else find this to be true?

I had one. I would never take one again. IMO it's a stupid solution to fixing what amounts to high stress. i bet your doctor has no bedside manners either.

Quote:

Originally Posted by RobiJo

I was never given a shot either, can't say I want one! The best thing about the vitrectomy is that you are knocked out and don't have to look at or focus on anything. You don't see or know what's about to happen.

Interesting

I was awake for most of mine, including another shot to the back of the eye socket. Mind you I was heavily sedated, so it barely bothered me.

Quote:

Vitrectomy is typically performed under local (injection) anesthesia, with sedation. In other words, the patient is awake during the procedure, but does not feel pain or see the procedure being performed. General anesthesia may be used instead in some cases. It is an outpatient procedure; no hospital stay is required.

I did see the procedure. The assistant didn't believe me, but I accurately described the vacuum cutter in action to him.