For people with glaucoma who are on medication and require additional therapy, or for those who have a more progressive form of the condition, laser therapy can be extremely effective. Lasers can be used to lower pressure in the eyes and prevent some types of glaucoma.
Laser trabeculoplasty is a brief, painless procedure that uses laser beams to stretch the drainage holes in your eye so eye fluid can flow out better. Your ophthalmologist performs this procedure in his or her office.
After placing numbing drops in your eye, your doctor holds a special lens on the eye. A high-intensity beam of light is aimed through the lens. It triggers a chemical and biological change in the tissue of the trabecular meshwork, the region that is blocking the fluid’s exit from the eye. The laser helps to improve drainage of fluid out of the eye and into the bloodstream.
Several types of laser therapy may be used, including argon laser trabeculoplasty, which treats about half of the meshwork; selective laser trabeculoplasty, which leaves small portions of it in place; and micropulse laser trabeculoplasty, which treats even smaller spots. Your doctor can determine which option is best for you.
Laser therapy can cause side effects, such as inflammation and pain. Your doctor may prescribe eye drops to control it or relieve soreness. He or she may also schedule several follow-up visits to monitor your eyes.
The results last anywhere from one to five years, sometimes longer. The pressure-lowering effects are similar to those of one or two eye drops. The procedure, however, doesn’t necessarily replace the need for medication.
Based on your response to the treatment, your doctor decides whether you need multiple sessions over several years.
A laser peripheral iridotomy procedure is most often used as the principal treatment for angle closure glaucoma. It’s also used as a preventive measure for those at risk of angle closure attacks, in which pressure suddenly builds in the eye. People with narrow or closed angles found during eye examination are at high risk of developing angle closure attacks.
Laser peripheral iridotomy uses a focused beam of light to create a very small hole on the outer edge of the iris. This opening allows fluid in the eye to flow between the anterior chamber—the front part of the eye—and the area behind the iris, the posterior chamber. Fluid therefore bypasses its normal route in which fluid flows in and out of the eye through a drainage system located at an angle where the iris meets the cornea.
In the short term, the procedure stabilizes the pressure in the eye and corrects the abnormal iris position. Over time, it prevents angle closure glaucoma attacks.
Temporary side effects include blurred vision, mild inflammation, and increased pressure in the eye. A small number of people may notice glare or a line of light in their vision, although this usually disappears after a few months.