Laser iridotomy for glaucoma

Laser iridotomy uses a very focused beam of light to create a hole on the outer edge, or rim, of the iris, the colored part of the eye. This opening allows fluid (aqueous humor) to flow between the anterior chamber, the front part of the eye, and the area behind the iris, the posterior chamber. This opening may decrease pressure in the eye and usually prevents sudden buildup of pressure within the eye, which occurs during an episode of acute closed-angle glaucoma.

Some people feel a sensation of heat in the eye during laser surgeries. However, there usually is no pain after laser iridotomy.

Laser iridotomy can be done without admitting the person to a hospital. The person may need to see his or her doctor 1 hour after laser surgery and then 1 day to 1 week after the surgery. The person will need to see the doctor for another checkup 6 weeks after laser surgery.

Laser iridotomy is used to:

• Treat closed-angle glaucoma after the pressure in the affected eye has been reduced with medication or when medications fail.
• Prevent closed-angle glaucoma in people who have narrow drainage angles and those people who have had closed-angle glaucoma in their other eye.

Laser iridotomy can prevent further episodes of sudden (acute) closed-angle glaucoma.

Laser iridotomy can usually prevent slow-forming (subacute) closed-angle glaucoma in people who are at risk for closed-angle glaucoma.

Sometimes people can take less medication to treat glaucoma after having laser iridotomy.

Complications of laser iridotomy may include:

• Brief blurred vision (common).
• Swelling of the clear covering (cornea) of the iris.
• Bleeding.
• Increased pressure in the eye.
• Closure of the new opening. A second surgery might be needed if the new opening closes.
• Burn to the inner lining of the eye (retinal burn). This is a very rare complication.

Later complications that may develop include:

• Worsening of clouding of the lens (cataract) that was present before laser treatment.
• Closure of the opening.
• Recurrent closed-angle glaucoma.
• Development of another type of glaucoma.
• Continuing need for medications (depends on the person's condition before laser treatment).
• Glare from light entering through the new opening.

Closed-angle glaucoma usually affects both eyes over time. When sudden (acute) closed-angle glaucoma occurs in one eye and laser surgery has been done on that eye, laser iridotomy is usually done on the other eye to prevent the condition from developing. Without treatment, there is a 50% chance that closed-angle glaucoma will also develop in the unaffected eye.¹

High pressure in the eyes may continue after laser iridotomy. The person may need to be monitored closely for this even after the procedure. Some people may require additional treatment, such as eyedrops, to lower the eye pressure.

Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.

Citations

1. American Academy of Ophthalmology (2000). Primary Angle Closure (Preferred Practice Pattern). San Francisco: American Academy of Ophthalmology.