Further vision deterioration after argon laser photocoagulation in diabetic retinopathy

Out of 222 eyes with diabetic retinopathy, observed during a period of 6-42 months after argon laser photocoagulation, 66 (30%) became worse. The most common complication was a fast increase of previous existing macular oedema due to extensive and heavy macular treatment. Another complication was an increase of the neovascularisation due to the inadequate treatment of avascular zones and heavy-leaking areas and to the growth of the neovascular tuft after the feeder vessel technique without previous peripheral ablation. Retinal and vitreal haemorrhages were frequent in this group. Fibrous tissue formation and vascular pseudopapillitis were less frequent complications. Large coagulations outside the macular area (peripheral ablation) are necessary to destroy the zones of borderline nutritional supply, which probably are closely related to the new vessel formation. The feeder vessel technique must not be used without a peripheral ablation although it may be of great help in destroying prepapillary or large neovascularisation.