Ms. j

[sand1]

If in one eye one's PDR is active and they have new blood vessel growth and already had about 1200 laser spots, do they need more to avoid having the new blood vessels bleed, and if so how many more may they need, what is the minimal/maximum?  And what voltage setting is safe for giving the laser spots? Does having a lot of pain with each laser spot matter?  (6 questions, 6 answers please)

If in one eye one's PDR IS INACTIVE and they DO NOT HAVE ANY NEW BLOOD VESSEL GROWTH, and already had about 1200 laser spots, do they need any more, if so why and how many?  Does one get laser spots (surgery) just because there is SPACE for it, although there isn't any activity? (4 questions, 4 answers please)  Thank you!

[John C Hagan III, MD, FACS, FAAO]

1. NV usually requres more laser spots. 2. How many they need varies from individual to individual 3. THere is no minimum and there is no maximum. Some eyes have had over 3000 spots n them. 4. The laser power varies also. Burns are usually "medium" 5. The procedure can be painful and some time anesthesia is given. 6. More spots may be necessary in inactive PDR due to macular edema or lipid leakage 7. # of spots varry 8. treatment is not based on the amount of space left to put in burns but by the type and severity of the diabetic eye disase present.

JCH III MD

[John C Hagan III, MD, FACS, FAAO]

Some of the things that might require more spots include: recurrence of PDR, diabetic macular edema, localized bleeding, localize leakage of cholesterol, large areas of ischemic retina. There is a classification system for PDR based on how many quadrants have PDR.

JCH IIIMD

[sand1]

Thanks for your answer, it was helpful, however to expound on your comment regarding question from Sand1 on 2/7/08 @ 4:39 p.m. - that "more spots may be necessary in inactive PDR due to macular edema or lipid leakage," does that mean that one must have these conditions as a criteria in receiving more spots?  What "type" and how "severe" does PDR have to be for more spots, since it's not determined by how much "space" there is for laser?  Thank you.