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Laser Iridotomy for Glaucoma

Surgery Overview

Laser iridotomy uses a very focused beam of light to create a hole on the outer edge, or rim, of the iris, the colored part of the eye. This opening allows fluid (aqueous humor) to flow between the anterior chamber, the front part of the eye, and the area behind the iris, the posterior chamber. This opening may decrease pressure in the eye and usually prevents sudden buildup of pressure within the eye, which occurs during an episode of acute closed-angle glaucoma.

Some people feel a mild but sharp sensation in the eye during this procedure. But there usually is no pain after laser iridotomy.

What To Expect

Laser iridotomy can be done without admitting the person to a hospital. The person may need to see his or her doctor 1 hour after laser surgery. The person will also need to see the doctor for a follow-up exam as recommended.

Why It Is Done

Laser iridotomy is mainly used to:

  • Treat closed-angle glaucoma after the pressure in the affected eye has been reduced with medicine or when medicines fail.
  • Prevent closed-angle glaucoma in people who have narrow drainage angles and those people who have had closed-angle glaucoma in their other eye.

How Well It Works

Laser iridotomy can prevent further episodes of sudden (acute) closed-angle glaucoma.

Laser iridotomy can usually prevent slow-forming (subacute) closed-angle glaucoma in people who are at risk for closed-angle glaucoma.

Sometimes people can take less medicine to treat glaucoma after having laser iridotomy.

Risks

Complications of laser iridotomy may include:

  • Brief blurred vision (common).
  • Swelling of the clear covering (cornea) of the iris.
  • Bleeding.
  • Increased pressure in the eye.

Later complications may include:

  • Further clouding of the lens (cataract) compared to what was present before laser treatment.
  • Closure of the opening.
  • Recurrent closed-angle glaucoma.
  • Development of another type of glaucoma.
  • Continuing need for medicines (depends on the person's condition before laser treatment).
  • Glare or double vision from light entering through the new opening.

What To Think About

Closed-angle glaucoma usually affects both eyes over time. When sudden (acute) closed-angle glaucoma occurs in one eye and laser surgery has been done on that eye, laser iridotomy is usually done on the other eye to prevent the condition from developing. Without treatment, there is a 50% chance that closed-angle glaucoma will also develop in the unaffected eye.footnote 1

High pressure in the eyes may continue after laser iridotomy. The person may need to be watched closely for this even after the procedure. Some people may need additional treatment, such as eyedrops or surgical iridectomy, to lower the eye pressure.

References

Citations

  1. American Academy of Ophthalmology (2010). Primary Angle Closure (Preferred Practice Pattern). San Francisco: American Academy of Ophthalmology. Also available online: http://aao.org/ppp.

Credits

ByHealthwise Staff
Primary Medical ReviewerAdam Husney, MD - Family Medicine
Christopher Joseph Rudnisky, MD, MPH, FRCSC - Ophthalmology

Current as ofDecember 3, 2017


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