Abstract
Purpose To determine whether macular photocoagulation has any effect on refraction in diabetics.
Methods This was a prospective study of 12 eyes of 12 diabetics with refraction at 2 weeks before and at 4 weeks and 4 months after argon laser. This was combined with a questionnaire survey of attitude among ophthalmologists on prescribing spectacles for diabetics awaiting macular laser. The main outcome measure was the spherical equivalents (SEQ) before and after treatment.
Results Only 36% of ophthalmologists surveyed would prescribe corrective lenses in patients waiting for macular photocoagulation. The median change in magnitude of SEQ at 4-6 weeks post-laser compared to pre-laser was 0.36 D (interquartile range 0.18-0.50 D). The median change in SEQ at 4 months was 0.25 D (interquartile range 0.12-0.56 D). These changes in SEQ from pre-treatment values were not statistically significant on Wilcoxon signed-rank test (p = 0.17 and 0.10, respectively). The correlation coefficient between difference and average SEQ was 0.02 (95% CI -0.14 to 0.19, p = 0.75) at 4 weeks and 0.11 (95% CI -0.06 to 0.275, p = 0.17) at 4 months, indicating no tendency for change in refraction with increasing ametropia.
Conclusion This pilot study implies that argon laser photocoagulation in diabetic maculopathy does not alter refraction. Prescription of corrective lenses can be performed prior to laser therapy, if required.
Similar content being viewed by others
Article PDF
References
Klein R, Klein BE, Moss SE . The long-term incidence of macular edema. The Wisconsin Epidemiologic Study of Diabetic Retinopathy XV. Opthalmology 1995;102:7–16.
Hammond CJ, Shackleton J, Flanagan DW . Comparison between an ophthalmic optician and an ophthalmologist in screening for diabetic retinopathy. Eye 1996;10:107–12.
Early Treatment of Diabetic Retinopathy Study Research Group. Photocoagulation of diabetic macular edema. Arch Ophthalmol 1985;103:1796–806.
D Abrams . Duke-Elder's practice of refraction. 10th ed. London: Churchill-Livingstone, 1993.
Wang Q, Klein BE, Moss SE . Refractive status in the Beaver Dam Eye Study. Study. Invest Ophthalmol Vis Sci 1994;35:4344–7.
Bland JM, Altman DG . Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986;I:307–10.
Tong L, Vernon SA . Passing the DLVA field regulations following bilateral macular photocoagulation in diabetics. Eye 2000;14:35–8.
Braun CI, Benson WE, Remaley NA, Chew EY, Ferris FL III Early Treatment of Diabetic Retinopathy Study Research Group. Accommodative amplitudes in the Early Treatment Diabetic Retinopathy Study. ETDRS report 21. Retina 1995;15:275–81.
Shahidi M, Ogura Y, Blair NP, Zeimer R . Retinal thickness change after focal laser treatment of diabetic macular oedema. Br J Ophthalmol 1994;78:827–30.
Kremser B, et al. Retinal thickness analysis in subjects with different refractive conditions. Ophthalmologica 1999;213:376–9.
Keller JT, Poise KA . Central serous retinopathy with transitory monocular hypermetropia: a case report. Am J Optom Arch Am Acad Optom 1972;49:793–6.
Sjolie AK, Mortensen KK . Visual acuity and refraction in type 1 diabetic patients aged 25-34 years. Acta Ophthalmol (Copenh) 1991;69:552–4.
Tso MOM . Pathological study of cystoid macular oedema. Trans Ophthalmol Soc UK 1980;100:408–13.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Sim, K., Tong, L. & Vernon, S. Does macular laser alter the refraction in a diabetic with maculopathy? A pilot study. Eye 15, 591–594 (2001). https://doi.org/10.1038/eye.2001.191
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1038/eye.2001.191