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Diabetes And Laser Eye Surgery

Can Diabetics Undergo Laser Eye Surgery?

Whether or not you’ll be able to have laser eye surgery will largely depend on the type of diabetes you have.

Patients with Type 1 diabetes typically need to control their blood sugar levels with insulin, while those living with Type 2 diabetes may be able to manage the disease with diet. It could be that medication such as metformin is also used in cases where diet alone is unsuccessful. Diabetes can cause a condition called diabetic retinopathy, during which the blood vessels and light-sensitive tissue towards the back of the retina are damaged. If this is found to be the case, you may be eligible to have the condition treated with a laser, although it will not be the same laser or the same kind of treatment associated with typical laser eye surgery.

Having laser eye surgery to correct your vision can in some cases be complicated by diabetes. For example, if you have pre-existing or mild diabetic retinopathy as mentioned above, this may deter surgeons from carrying out the procedure, but it may be possible if your condition does not affect the central part of your vision. It is also important to ensure that your blood sugar levels are well controlled to optimize the effectiveness of laser vision correction and to ensure the effects last. As blood sugar levels fluctuate, your glasses prescription will fluctuate as well, and so it can be difficult for your surgeon to take an accurate measurement if your blood sugars are poorly controlled. To avoid the laser failing to correct your eyes and achieve the desired effects, you should ensure your blood sugar levels are kept stable and are at a normal level on the day of your reading.

Patients with diabetes typically experience slower rates of healing than those who don’t, which can mean the recovery time following laser eye surgery is longer. For this reason, many surgeons will insist using procedures such as IntraLASIK, given the faster healing time than traditional LASIK.

Possible Complications With Laser Eye Surgery For Diabetics

Diabetics generally need to have regular eye checks as they are highly prone to suffering from retinopathy as one of the complications of the disease. This can be a serious condition which can result in vision reduction or even blindness in severe cases. If it is caught early on, then laser surgery can sometimes treat the condition, particularly if you suffer from macula or proliferative retinopathy. The treatment in these cases will stop the condition getting any worse, but it will not bring back any vision that has already been lost.

If you are interested in laser eye surgery for myopia or long-sightedness, it may be possible, but it won’t be suitable in all cases as the diabetes can cause abnormalities in the cornea which can be exacerbated by laser eye surgery. For patients with diabetes who are interested in this type of surgery, their first point of contact should be a specialist eye surgeon, ideally one who has experience of treating diabetics. Patients can ask their GP to recommend a surgeon to them.

Is It Possible To Avoid Developing Retinopathy?

While retinopathy is a common condition in sufferers of diabetes, particularly those with type 1, the risk of it developing can be reduced. Risk factors include:

  • The length of time you have had diabetes (retinopathy is found in 90% of patients who have had diabetes for over 30 years)
  • Poor glucose control
  • High blood pressure
  • Kidney disease
  • Pregnancy
  • High cholesterol
  • Obesity
  • Smoking

To minimise the chance of developing retinopathy, patients are therefore advised to maintain a healthy BMI, take regular exercise, maintain well controlled glucose levels through a healthy diet, reduce blood pressure and stop smoking. However, even if all this advice is followed, a proportion of diabetics with well controlled glucose and a healthy lifestyle will still develop retinopathy, although it’s also safe to say that diabetics who lead a healthy lifestyle and do develop retinopathy are much less likely to see it progress to the more serious stages. This is why all diabetics are required to have an eye test at least on an annual basis.

How Does The Laser Treatment Work?

In retinopathy, there are leaks of fluid and tiny bleeds in the retina which restrict the blood flow and cause new abnormal blood vessels to grow. The laser treatment can be used to seal the blood vessels so they no longer leak and create burns which prevent new vessels growing. This process is known as photocoagulation. The burns made by the laser are tiny and can treat the smallest blood vessels. In fact, the treatment may require several hundred of these burns and will often take several sessions to be fully complete.

The procedure is not painful but patients can feel a pricking sensation during the treatment. Generally, as you have more sessions, the level of discomfort will increase. If you find it particularly uncomfortable, you can request a sedative prior to the procedure.

After each session, the patient’s sight will often become slightly blurry or dimmed. This is quite usual and will disappear in a few days. However, if the laser treatment does not work or if the retina detaches, you may require further surgery on your eye.
Preparing For Surgery

Before the surgery, patients are advised to monitor their glucose levels carefully and lose any excess weight. You should also bring dark glasses with you to each appointment and arrange a lift as you will not be able to drive following the operation.
After-care

After surgery you can take mild painkillers such as paracetamol to ease any discomfort and take the remainder of the day to rest quietly at home. Keep your sunglasses on as you may feel more sensitive to light for a while. It’s also recommended to have a friend or relative stay with you for a few hours to help you if needed.

You may also be advised not to wear eye make-up or get water in your eye for up to a month. Patients can return to work the next day, but some prefer to take a couple of days off in case of prolonged blurred vision. You may notice a permanent reduction in your night vision.

Is The Procedure Available On The NHS?

Treatment for diabetic retinopathy is available on the NHS, but waiting times can vary significantly from region to region. If you are interested in getting the treatment on the NHS you should contact your local GP, or you can wait to be referred after your annual eye examination. However, if you feel your eyesight is deteriorating, then you should not simply wait for you annual eye test to come around, as the sooner it is treated the less sight you will lose.

Alternatively, there are a number of private clinics who offer this service for a fee of around £2,000. Private clinics will also often offer a finance package which will allow you to spread the payments over 12 months.

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