Patients with glaucoma may benefit from two major types of laser treatments. Both treatments can be performed in the office without needing to go to an operating room. Most patients are able to return to work the following day. The laser treatments are aimed at improving the internal drainage system of the eye. A different laser is used depending on the type of glaucoma.
Laser trabeculoplasty is used to treat open-angle glaucoma. The angle refers to the internal drainage system of the eye. As you age, the internal drainage system can become microscopically damaged. This damage causes the pressure to increase inside that eye, which injures the optic nerve. Over time, optic nerve injury leads to blindness. The laser is directed at the internal drain of the eye. This improves the flow of fluid out of the eye.
Most patients have an excellent treatment outcome with minimal risks. The pressure lowering effect can last up to two years. At that time, the laser can be repeated. It takes about 6-8 weeks to determine if the laser was effective. If effective, many patients do not need to continue using eye drops. Unlike most lasers, the treatment is not painful. It does require a contact lens to be placed on the eye, which may distort vision temporally. In addition to blurring the vision, the risks may include inflammation, not lowering the pressure or increasing the pressure. To counter these effects, pressure lowering drops are given before the treatment. In addition, the pressure is checked immediately after the treatment and in 6 weeks. The inflammation is treated with a short 5-day course of anti-inflammatory drops.
Laser iridotomy is used to treat closed-angle glaucoma. The angle is not visible in these patients. The lack of a visible angle can be due to scarring, advanced cataract or chronic inflammation. Additionally some patients are born with a very narrow approach to the drainage system of the eye. One third of these patients can obstruct the drain and have an acute elevation in eye pressure. To prevent this acute closure of the drain, a laser iridotomy is performed.
The iridotomy is a small hole created in the iris or colored part of the eye. It allows fluid from the back of eye to access the angle. It can be painful, but usually does not have to be repeated. The pain is due to creating the hole in the iris. In most cases, the pain is temporary and resolves after the laser is completed. The risks include blurred vision, increased eye pressure and inflammation. To counter these affects, pressure lowering drops are given before the treatment. In addition, the pressure is checked immediately after the treatment and in 6 weeks. The inflammation is treated with a short 5-day course of anti-inflammatory drops.
Dr. Ninita Brown, of Metrolina Eye Associates has been trained in these procedures as a glaucoma specialist. To see if either a laser trabeculoplasty or iridotomy can help you, please call our contact office today .
By Ninita Brown, MD