Can Excessive Laser Treatment in Retinal Detachment Surgery Cause Macular Pucker?

Retinal detachment surgery

Hello Dr.
Gao, thank you for your prompt response to my question.
I appreciate it.
However, I have another question.
Besides postoperative inflammation from retinal surgery potentially leading to macular epiretinal membrane formation, could excessive laser treatment during retinal detachment surgery also contribute to the development of a macular epiretinal membrane? For example, if three laser sessions were performed, each with over a hundred shots.
Thank you, John.

John, 40~49 year old female. Ask Date: 2016/10/07

Dr. Gao Pilin reply Ophthalmology

Hello John, if the injection is only administered around the periphery, the macula should not develop a proliferative membrane.
However, after retinal detachment, such phenomena can occur.
In Taiwan, the ophthalmology department at Puzi Hospital is open Monday to Friday from 8:00 AM to 12:00 PM and Wednesday afternoons from 1:00 PM to 4:30 PM.
Please note that online responses are for reference only; it is essential to seek medical attention at a healthcare facility if necessary.
I hope to have the opportunity to assist you.
Gao Pi-Lin

Reply Date: 2016/10/07

More Info

Hello John,
Thank you for your question regarding the potential complications associated with excessive laser treatment during retinal detachment surgery, specifically concerning the development of a macular pucker. This is an important topic, as understanding the risks associated with surgical interventions can help patients make informed decisions about their treatment options.

A macular pucker, also known as epiretinal membrane, occurs when a thin layer of scar tissue forms on the surface of the retina, particularly in the macula, which is responsible for sharp central vision. This condition can lead to visual disturbances, including blurred or distorted vision. While there are several factors that can contribute to the formation of a macular pucker, including aging and retinal tears, surgical interventions such as retinal detachment repair can also play a role.

In the context of retinal detachment surgery, laser treatment is often employed to secure the retina and prevent further detachment. However, excessive or aggressive laser treatment can indeed lead to complications. When laser energy is applied to the retina, it causes thermal damage to the tissue, which can trigger a healing response. In some cases, this healing response can result in the formation of scar tissue, leading to a macular pucker.

The number of laser applications and the total energy delivered during the procedure are critical factors. While a few laser spots may be necessary to achieve the desired outcome, excessive applications—such as three sessions with over a hundred laser spots each—can increase the risk of scar tissue formation. This is particularly true if the laser is applied to areas close to the macula, as the macula is more sensitive to damage and scarring.

It is also worth noting that the risk of developing a macular pucker is not solely dependent on the amount of laser treatment but also on the individual’s healing response. Some patients may be more prone to scar tissue formation due to genetic factors or pre-existing conditions, while others may heal without complications.

In summary, while laser treatment is a critical component of retinal detachment surgery, excessive use can indeed increase the risk of developing a macular pucker. If you have concerns about the amount of laser treatment you received or are experiencing visual changes, it is essential to discuss these issues with your ophthalmologist. They can evaluate your specific situation, conduct a thorough examination, and provide guidance on potential treatment options if a macular pucker is present.

In conclusion, while laser treatment is necessary for the successful repair of retinal detachment, moderation is key to minimizing the risk of complications such as macular pucker. Regular follow-up appointments and open communication with your eye care provider are crucial for monitoring your recovery and addressing any concerns that may arise.

Best regards,
Doctor Q&A Teams

Similar Q&A

Understanding Retinal Tears: Causes, Risks, and Post-Surgery Concerns

Hello Doctor, I have retinal holes in both eyes and have undergone laser treatment for them. However, after the treatment on my right eye (where the original hole seemed a bit large), I developed a small hole next to it within a month during my follow-up visit, so it was treated ...

Dr. Gao Pilin reply Ophthalmology
Hello: The cause of lattice degeneration of the retina is unknown, and it commonly occurs in myopic individuals, not necessarily only in those with high myopia. The use of digital devices (3C) does not cause retinal detachment unless there are existing holes or lesions in the ret...

Activities That May Harm Your Retina: Expert Advice for Eye Health

Dear Dr. Hu, Hello! I apologize for bothering you. In October 2007, I underwent two retinal reattachment surgeries on my left eye due to retinal detachment caused by high myopia (the procedures were scleral buckle surgeries). After the first reattachment surgery, the retina deta...

Dr. Hu Yusheng reply Ophthalmology
Hello: You mentioned that you have had surgery and laser treatment on your left eye, and laser treatment on your right eye, as well as whether your current lifestyle needs adjustment. Generally, you should pay attention to the following: 1. Avoid rubbing your eyes or applying pre...

Understanding Retinal Laser Treatment and Its Risks for High Myopia

I have some questions for Dr. Gao. I am highly myopic with a prescription of -950 diopters and have recently been experiencing arc-shaped flashes of light passing through the corner of my eye (occurring about five times a day, particularly when laughing, just after waking up, or ...

Dr. Gao Pilin reply Ophthalmology
Hello: Will performing laser treatment on the retina during PVD increase the risk of retinal detachment? Answer: It should not. Is it possible that the retina is in a more fragile state two weeks after the laser treatment, making the vitreous traction on the retina more significa...

Understanding Retinal Detachment: Symptoms, Treatments, and Concerns

In early January of this year, I suddenly experienced an increase in floaters and noticed something flashing in the lower right part of my eye. Later, I occasionally saw light flashing. At the end of January, I visited a clinic, and the doctor diagnosed me with a retinal tear and...

Dr. Gao Pilin reply Ophthalmology
Hello, BB: If this is the case, it is possible that the retinal detachment is gradually worsening, as you are already experiencing blurred vision. I recommend that you return for a follow-up appointment and discuss your condition with your physician to determine if urgent surgica...