Can Retinal Tears Reoccur After Laser Treatment? Your Eye Health

After laser treatment for a retinal tear, is it possible for another tear to occur in the same area?

Hello, I am highly myopic with a prescription of approximately -1000 diopters.
I undergo a fundus examination every six months to monitor the condition of my retina.
During my routine examination six months ago, the clinic physician informed me that there was a tear in my right retina, and I underwent laser treatment on the same day.
Upon follow-up, the physician indicated that the condition was good and advised me to continue with the semi-annual check-ups.
Recently, I had another fundus examination at National Taiwan University Hospital, and to my surprise, the physician stated that there is indeed a tear in my right eye, but he could not see any signs of previous laser treatment.
He suggested that I undergo another round of laser treatment.
I would like to ask, should there be evidence of laser treatment on the retina after the procedure? Is it possible for the same area to show no signs of treatment at all? Does this mean that I would need to have laser treatment every time there is a tear? Or could there be other reasons for this? I am quite confused and would appreciate your response!

Vicky, 20~29 year old female. Ask Date: 2004/04/15

Dr. Zhang Zhengzhong reply Ophthalmology

Hello Vicky,
First, I would like to apologize for the delay due to Director Chang's busy schedule.
I will address your concerns here:
For patients with high myopia, regular retinal examinations are essential, and you are doing well in this regard.
According to your description, there was a previous examination six months ago where laser photocoagulation was performed on a tear in your right eye.
In normal circumstances, laser photocoagulation creates a firm adhesion between the retina and the choroid within four to five weeks post-treatment.
The degree of adhesion can be assessed by observing changes in pigmentation on the retina.
Therefore, it is generally recommended to have a follow-up appointment one month after the laser treatment.
If the pigmentation changes are not significant, it is usually interpreted as insufficient adhesion caused by the laser, and a repeat laser treatment may be advised.
The absence of scarring likely refers to the lack of noticeable pigmentation changes.
If a new tear is found within the area previously treated by the laser, no additional laser treatment is necessary.
However, if a new tear occurs outside the previously treated area, to prevent further retinal detachment, additional laser treatment is still recommended.
Best wishes,
Dr.
Liu Ching-Hsiang
Attending Physician, Department of Ophthalmology
Chung Hsing Hospital
Tel: 02-25523234-6278
E-mail: [email protected]

Reply Date: 2004/04/15

More Info

Retinal tears can indeed reoccur after laser treatment, and understanding the underlying mechanisms is crucial for managing your eye health effectively. In your case, as a person with high myopia (approximately -10.00 diopters), you are at an increased risk for retinal issues, including tears and detachments. This is primarily due to the structural changes that occur in the eye as a result of high myopia, which can lead to thinning of the retina and increased susceptibility to tears.

When a laser treatment is performed on a retinal tear, the goal is to create a scar around the tear to seal it and prevent fluid from accumulating behind the retina, which could lead to a retinal detachment. Typically, after a successful laser treatment, there should be visible signs of the procedure on the retina, such as a white or grayish area where the laser has been applied. However, the absence of visible laser marks does not necessarily mean that the treatment was ineffective. It is possible that the laser treatment was successful in sealing the tear, but the healing process may not always leave prominent marks.

Regarding your concern about the possibility of needing repeated laser treatments, it is important to note that while laser treatment is effective, it does not guarantee that new tears will not develop in the future. The risk of new retinal tears can be influenced by several factors, including the degree of myopia, the overall health of the retina, and any changes in your vision or symptoms. Regular follow-up examinations, as you are already doing, are essential for monitoring the condition of your retina.

If a new tear is detected, your ophthalmologist may recommend additional laser treatment. The decision to retreat a specific area depends on various factors, including the characteristics of the tear, the presence of any new symptoms (such as flashes of light or an increase in floaters), and the overall health of your retina. It is not uncommon for patients with high myopia to require multiple treatments over time, especially if they are prone to developing new tears.

In summary, while laser treatment is a valuable tool in managing retinal tears, it does not eliminate the risk of future tears. Regular eye examinations are crucial for early detection and management of any new issues. If you have concerns about your treatment or the condition of your retina, do not hesitate to discuss them with your ophthalmologist. They can provide personalized advice based on your specific situation and help you understand the best course of action for maintaining your eye health.

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