Some people may need eye surgery to control their glaucoma. Lasers are very useful for treating glaucoma because they avoid cutting and have a lower chance of complications (compared to glaucoma surgery).
There are three common laser procedures:
Laser trabeculoplasty
Peripheral iridotomy
Laser cyclophotocoagulation
Laser trabeculoplasty or selective laser trabeculoplasty improves the outflow of aqueous fluid. A laser is used to make from 50 to 100 tiny burns in the trabecular meshwork. The procedure opens up the mesh-like outflow pathway to improve draining of fluids from the eye. Sometimes your doctor may perform this procedure over two visits. The benefit of the treatment may last for several years, but it is not a cure. Half the people who have this surgery need additional treatment within two years. Laser trabeculoplasty may be used to treat patients who had a good first effect with laser treatment, but over time have lost some of the pressure-lowering response.
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A peripheral iridotomy is most often used to treat narrow angle or angle closure glaucoma. The laser beam creates a tiny hole in the colored part of the eye (the iris). This lets the pressure in front of the iris become the same as the pressure behind the iris. As a result, the iris moves away from the drainage angle and the aqueous fluid can resume
draining normally.
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Laser cyclophotocoagulation is used for severe cases of glaucoma. It eliminates tiny areas of the ciliary body that make aqueous fluid. This "turns down the faucet."
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People usually don't feel any pain with these procedures, although some report a slight stinging. (Laser cyclophotocoagulation requires a numbing block to
the eye to prevent pain with the procedure.) Most
patients take it easy the day of their treatment, but go
back to their normal routine the following day.
Many people need to keep taking medicines even after
laser surgery.
Laser surgery is usually successful, but there are some risks. These include a temporary, generally short-term increase in eye pressure, temporary inflammation of the eye, and possibly a slightly increased risk of developing cataracts.
Treating Glaucoma with Medicines
Treating Glaucoma with Glaucoma Surgery
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