Does macular laser alter the refraction in a diabetic with maculopathy? A pilot study

Purpose To determine whether macular photo coagulation has any effect on re fraction in diabetics. Methods This was a prospective study of 12 eyes of 12 diabetics with refrac tion 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 o utcome measure was the spherical equivalents (SEQ) before and after treatme nt. Results Only 36% of ophthalmologists surveyed would prescribe corrective le nses 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 pretre atment values were not statistically significant on Wilcoxon signed-rank te st (p = 0.17 and 0.10, respectively). The correlation coefficient between d ifference and average SEQ was 0.02 (95% CI -0.14 to 0.19, p = 0.75) at 4 we eks and 0.11 (95% CI -0.06 to 0.275, P = 0.17) at 4 months, indicating no t endency for change in refraction with increasing ametropia. Conclusion This pilot study implies that argon laser photocoagulation in di abetic maculopathy does not alter refraction. Prescription of corrective le nses can be performed prior to laser therapy, if required.