ABSTRACT
This chapter aims to improve understanding of photothermal laser machine and techniques to get the ophthalmic trainee started with common retinal treatments, including PRP, sectoral PRP, focal laser treatment, and laser retinopexy. The advent of the argon laser marked a milestone in retinal photocoagulation. Two large RCTs, Diabetic Retinopathy Study and Early Treatment Diabetic Retinopathy Study, confirmed the beneficial effects of early photocoagulation in diabetic retinopathy (reduced moderate vision loss by 50%), and established argon laser as the treatment of choice for diabetic retinopathy. Ideal photo-coagulative treatment achieves therapeutic benefits while preserving visual function, without causing retinal damage. New concepts in photocoagulation include altering laser parameters to reduce retinal damage and improving delivery efficiency, accuracy, and safety. Conventional lasers are destructive, working on the principle of overt thermal damage to leaking blood vessels, creating oxygen bridges, reducing hypoxia by lowering oxygen demand, and decreasing retinal metabolic rate.
