Acute Complications of Argon Laser Photocoagulation

Initial clinical experience with argon laser photocoagulation is reported. Eighteen consecutive eyes (17 patients) were treated for epipapillary and peripapillary neovascularization with the argon laser. Nine eyes (50%) sustained complications, and six of these eyes had associated decrease in visual acuity. Complications generally occurred within 24 hours, and included vitreous hemorrhage, permanent nerve fiber bundle defect, optic neuritis, and branch arteriole occlusion. Vitreous hemorrhage was found to occur from disc neovascularization in spite of angiographically documented segmentation and closure that had been induced by the laser. If high milliwattage and many argon burns were required to segment and close neovascular tissue, there seemed to be increased risk of vitreous hemorrhage. At follow-up, ophthalmoscopy suggested regression of disc vessels in 61%, whereas fluorescein angiography showed actual decrease of perfusion in 46%.