Laser Iridotomy, Explained
Laser Iridotomy is a surgical eye treatment which is done in our Manhattan offices to treat angle closure glaucoma, a condition of increased pressure in the anterior chamber (front chamber) caused by acute (sudden) or chronic (slowly progressive) blockage of the normal circulation of fluid inside the eye. The block occurs at the angle of the anterior chamber that is formed by the junction of the cornea with the iris, which causes the intraocular pressure to build up. Laser Iridotomy at Eye Care on 5th is a highly effective procedure for treating most types of angle closure or narrow angle glaucoma.
This treatment is also performed prophylactically (preventively) on asymptomatic patients with narrow angles, and those with pigment dispersion. Individuals with a narrow angle usually have a higher risk of an acute angle closure, especially upon dilation of the eye. Pigment dispersion is a condition in which the iris pigment is shed and is dispersed throughout the anterior part of the eye. If the dispersion occurs because of bowing of the iris (the case in 60% of patients with pigment dispersion) a laser iridotomy at Eye Care on 5th will decrease the bowing or concavity of the iris and subsequent pigment dispersion. That decreases the risk of developing pigmentary glaucoma, -- a condition when the dispersed pigment may clog the trabecular meshwork.
Laser Iridotomyat Eye Care on 5th is also performed on the other eye of a patient who has an angle closure of one eye, since the probability of an angle closure in the second eye is 50%.
Other Indications for Laser Iridotomy
- It is also performed on patients with nanophthalmos (small eyes.)
- It may be recommended for patients with malignant glaucoma in order to identify the etiology of elevated IOP.
- It is the laser procedure used to treat pigmentary and pseudoexfoliation glaucoma.
- It cannot be performed if the cornea is edematous or opacified, nor if the angle is completely closed. Please ask your doctor for explanations.
Laser Surgery and Glaucoma – Potential Risks
- The biggest risk of laser iridotomy is an increase in intraocular pressure (IOP). As a rule, the IOP spike is transient and of concern to your Eye Care on 5th surgeon only during the first 24 hours after the treatment. However, if there is any damage to the trabecular meshwork during laser surgery, the IOP may not be lowered enough, which may require extended medical intervention or filtration surgery. This is a rare outcome, and one that will be monitored and treated with our usual level of intensive, expert attention.
- Anterior Uvetis (inflammation inside the eye) is the second greatest risk of this procedure. Usually the inflammation clears within several days following the procedure, although it can stay for up to 25-30 days. Always keeping your successful outcome and complete comfort in mind, your eye doctors at Eye Care will ensure that you have the very best follow-up care, which may include the application of some topical corticosteroids.
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Other risks of laser surgery for glaucoma could be as following:
- Swelling of the cornea
- Abrasions to the cornea
- Opacification of the cornea;
- Some damage to the corneal endothelium (the part of cornea delivering oxygen and nutrients into the iris)
- Some bleeding of the iris during surgery
- Minor glare and double vision (when the iridotomy hole is large, or if the eyelid does not completely cover the opening)