Laser Iridotomy (LI)

Laser peripheral iridotomy is the standard first-line treatment in closed angle glaucoma and eyes at risk for this condition.

Laser iridotomy is a surgical procedure that is performed on the eye to treat angle-closure glaucoma, a condition of increased pressure in the front chamber (anterior chamber) that is caused by sudden (acute) or slowly progressive (chronic) blockage of the normal circulation of fluid within the eye.

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Glaucoma Laser Treatment in Houston, TX

Laser Iridotomy creates a hole in the outer edge of the iris, leading to an opening of the angle in the majority of cases. After the angle is widened from the procedure, the trabecular meshwork is exposed and fluid outflow is enhanced.

It is recommended in eyes that have the angle closed for at least half the eye and have high eye pressure or glaucoma. In eyes that have a closed-angle but normal eye pressure and no optic nerve damage, laser iridotomy may be recommended as a preventive treatment.

In a recent large prospective study of such eyes, it was shown that there was an overall low risk of developing high eye pressure but the risk was lower among eyes that received laser iridotomy compared to those that did not.

The eye is usually pretreated about half an hour before with drops that make the pupil small. Just before the procedure, anesthetic drops are placed to numb the surface of the eye, a lens is then placed on the eye to perform the laser. The procedure usually takes 5-10 minutes and some patients may experience minor pain.

After the procedure, there is temporary blurriness of vision. The eye may be a little red, light sensitive, and/or uncomfortable, and there may also be a mild headache due to the eye drops given before the laser.

The eye pressure is usually assessed within 15 – 30 minutes after the laser and anti-inflammatory eye drops are usually prescribed for a few days.

Laser iridotomy is not a substitute for glaucoma eye drops in most cases if the patient is already on medication prior to the procedure. Although the angle widens in most cases after laser, normal age-related changes may subsequently alter the angle region. Cataract formation could close the angle again and cataract extraction may be required.

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