Leaf User Manual
P/N: 97-4000, Revision 08, Release date: 2020-11-10 Page 79 of 85
Adverse Effects and Complications
Posterior Segment Laser Procedures
The most common complication of panretinal photocoagulation is increased macular
edema usually with a concurrent decrease in visual acuity. In addition, blowout
hemorrhages from the areas of neovascularization, particularly on the optic nerve,
have been observed and may be caused by an increase in peripheral resistance
secondary to photocoagulation or by an inadvertent valsalva maneuver by the
patient.
Only a contact lens specifically designed for use with laser energy should be used.
Use of a standard diagnostic contact lens may result in a power loss due to reflection
from the surface of the lens. The reflected energy may pose a hazard to both the
patient and the physician.
Following photocoagulation, patients should be cautioned against any activity that
could increase the venous pressure in the head, neck or eyes, such as straining,
lifting or holding their breath. Patients should be advised to sleep with the head of
their bed elevated 15 to 20 degrees.
Patients should be cautioned against stifling a sneeze, because this raises the blood
pressure within the eyes to a high level. Vigorous nose blowing should also be
discouraged. Rubbing the eyes following photocoagulation may disrupt blood vessels
inside the eyes. Sneezing and coughing should be controlled with cough syrup or
other medications.
Immediately following treatment, patients should avoid altitudes over 2500 m (~8000 ft).
Anterior Segment Laser Procedures
Intraocular pressure should be closely monitored following laser iridotomy or
trabeculoplasty.
Hemorrhage from the trabecular meshwork occasionally occurs as an ooze of blood
from Schlemm’s canal to the site of laser impact. This is easily stopped by increasing
the pressure on the gonio lens on the cornea or by coagulating the bleeding site by
application of a laser burn.
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