Lasers have made dramatic changes in many different segments of eye surgery, including LASIK and other forms of refractive surgery, capsulotomy following cataract surgery, and retinal surgery. They have also significantly altered glaucoma treatment for both open angle and angle closure glaucoma. Laser surgery is now a treatment alternative that can reduce intraocular pressure and prevent ocular nerve damage. In many cases, laser surgery is not sufficient to completely reduce intraocular surgery, and the continued use of glaucoma eye drops may be necessary.
One major risk of laser glaucoma surgery is that many people experience a short-term post-surgical rise in intraocular pressure. Surgery patients and their ophthalmologists must monitor intraocular pressure carefully after surgery.
Laser peripheral iridotomy (LPI) is a surgery for the treatment of angle closure glaucoma. In people with narrow angles, angle closure sometimes occurs when the iris bunches up over the angle, blocking the drainage of aqueous humor and increasing intraocular pressure. To prevent this, LPI makes a small hole in the iris. This allows the iris to move away from the fluid channel and allows fluid to drain through the iris.
Laser trabeculoplasty is a treatment for open angle glaucoma. In this procedure, a laser is used to increase drainage through the filtration angle by creating holes through the angle's meshwork. There are several variations on this procedure.
Argon laser trabeculoplasty (ALT) is the oldest version of the procedure. The laser burns holes in the meshwork. treatment is performed in stages to avoid creating more drainage than is necessary, but also to reduce the risk of dangerous increases in intraocular pressure following surgery. The intraocular pressure increases are due to swelling related to surgery that actually closes the angle in the short term.
Selective laser trabeculoplasty (SLT) is a refined version of the procedure. SLT uses a combination of laser frequencies to selectively treat only certain cells in the meshwork. This results in less thermal damage to the meshwork of the angle, reducing the likelihood of dangerous elevations in intraocular pressure after surgery.
Micropulse laser trabeculoplasty (MLT) is another version of laser trabeculoplasty designed to reduce the likelihood of dangerous spikes in intraocular pressure following surgery. Using a diode laser, energy is delivered to the meshwork in a series of very short pulses, raising the temperature of the meshwork very gradually. This technology is currently under investigation, but may soon be available.
People rarely experience any significant discomfort that lingers past the laser surgery. Most patients can resume normal daily activities the day following surgery.
Laser surgery is very effective at reducing intraocular pressure of glaucoma sufferers. As a result, it can dramatically reduce the risk of vision loss resulting from glaucoma. It is not normally effective enough to be used as a sole treatment for glaucoma, and most people will still require eye drops to control glaucoma.
Learn more on Questions about Laser Glaucoma Surgery.
The sooner you receive treatment for glaucoma, the more likely you are to be able to preserve your vision. Early glaucoma diagnosis can be accomplished with regular eye exams. Find a local ophthalmologist to schedule a vision exam today.