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Transscleral Diode Laser Infrared (Non-Thermal) Photocoagulation for Retinal Tears and Detachments

Several years ago, for the first time in Connecticut, we used a new form of laser technology to repair a retinal tear on a patient experiencing flashers and floaters. Diode Laser Transscleral Retinal Photocoagulation is a new technique of retinopexy (retinal adhesion) now available for our patients.

Traditionally, posterior retinal tears could be managed by transpupillary laser. However, media opacity, such as cataracts, capsular opacities or vitreous hemorrhages may make this form of retinopexy challenging or impossible, since it is difficult for the laser to penetrate the opacities. In these cases, cryopexy (freezing to induce adhesions) is used. Cryopexy is also used to treat anterior tears, which are difficult to reach by laser. The drawback to cryopexy is that it often results in increased inflammation and postoperative discomfort from the freezing pain.

Now, cryopexy can be eliminated by using an infrared (810 nanometer) wavelength laser delivered externally through the sclera. The laser is absorbed by ocular pigment, creating a permanent adhesion between the inner choroid and retinal pigment epithelium and neurosensory retina. Retinal adhesion is established days sooner than with cryopexy and most patients experience little or no post-treatment discomfort.

Content written by Dr. David Tom, FACS