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Laser Treatment in Glaucoma

Glaucoma laser surgery is usually done in a clinic and it is painless. During laser, a tiny but powerful beam of light is used to treat a part of the eye .
The following are the most common laser surgeries to treat glaucoma.

LASER PERIPHERAL IRIDOTOMY.

  • Used in treatment of narrow angle glaucoma. It makes a small hole in the periphery of the iris and helps to drain the fluid.
  • It helps to open the angle and helps in improved drainage of the fluid.
  • Reduces chances of extreme fluctuations in eye pressure.
  • Prevents sudden increase in eye pressure which can lead to an acute attack of angle closure glaucoma.

How is it done?

  • Local anaesthetic drops are instilled in the eye.
  • A lens in kept over the eye to focus the laser energy, and to keep the eye still.
  • Laser is focused on the iris and a small laser hole is created.
  • There will be no pain during the procedure; however, you might feel a small jerky sensation in the eye as the laser is being done.
  • The doctor will need you to keep your eyes steady during the laser.
  • Post laser eye steroid eye drops will be prescribed.
  • Continue all other glaucoma medications being taken by you, unless instructed otherwise.
  • Your vision may be slightly blurred on the day of the laser.

LASER TRABECULOPLASTY

Used in the treatment of open angle glaucoma, the laser beam opens the fluid channels of the eye. Low powered laser burns are placed on the drainage meshwork which drains the fluid in the eye. Low powered laser burns are placed on the drainage meshwork which drains the fluid in the eye. Usually half of the fluid channels are treated first and if necessary the other channels are treated in a separate session.

Laser trabeculoplasty can be done using:

  • Argon laser: Argon laser trabeculoplasty ( ALT)
  • Diode laser: Diode laser trabeculoplasty ( DLT)
  • Selective laser trabeculoplasty.(SLT)

All three lasers cause an equal amount of eye pressure reduction.
However, the pressure reduction obtained with laser trabeculoplasty is temporary; it tends to wane over time. Also one might not be able to stop all drops that a patient is using.
Also, in the immediate post laser period, one might have acute increases in eye pressure, which might be damaging to an already compromised eye. Therefore, this technique is not preferred in advanced glaucoma's.

SLT uses a combination of frequencies that allow the laser to work at low levels. It treats specific cells selectively, leaving untreated portions of the channel intact. Therefore, this might be more repeatable compared to the other lasers. However, eye pressure reduction is very similar compared to other laser techniques.

ENDOSCOPIC CYCLOPHOTOCOAGULATION

This is done to decrease the production of the fluid in the eye by lasering the site of production in the eye, the ciliary body. This procedure is reserved for end stage, and complicated glaucomas. This can be done through the external route, i.e., trans scleral photocoagulation, or by the more precise internal endoscopic route, namely endoscopic cyclophotocoagulation. Endoscopic Cyclophotocoagulation has better profile in terms of vision preservation compared to transcleral Cyclophotocoagulation.

These procedures are not meant for primary treatment of glaucomas ,and are reserved for complicated situations.
It is mainly used to save the eye from severe glaucoma damage not being managed by standard glaucoma surgery

Glaucoma surgery is done to maintain the existing vision in the eye. It cannot improve vision, or restore vision that has been already lost.







General Information about Glaucoma

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