What is a laser iridotomy ?

A laser iridotomy is a hole made in the outer part of the iris using a laser beam. It is a surgical procedure that is performed on an eye with angle closure 


Why is it needed ?

In eyes with angle closure the trabecular meshwork (from where fluid drains out of the eye) is covered or partially blocked by the peripheral iris. The main resistance to flow is often at where the iris meets the lens of the eye. By creating a hole in the peripheral part of the iris with the laser this allows a bypass for fluid to drain into the trabecular meshwork and opens the angles therefore decreasing the chances of further blockage of the trabecular meshwork.

The proedure may be done to prevent or treat an acute attack of primary angle closure glaucoma or to treat a narrow angle that is occludable.  It is designed to preserve vision and will not improve the sight 


What happens on the day of treatment ?

The treatment is carried out as an outpatient. The procedure itself takes approximately 15 minutes but you will be in the hospital for 1-2 hours. 

First you will have some drops in the eye to constrict the pupil. Following this a drop of anaesthetic will also be applied to your eye to allow us to place a large contact lens on the eye. The contact lens helps focus the laser as well as preventing blinking. Once the procedure is under way you may see some bright flashes, hear a clicking or tapping sound. There may be a feeling of slight discomfort like a pin touching the eye. 

After the procedure you may return home. You will be given some additional drop for a few days to prevent inflammation and a rise in eye pressure. As the vision may remain blurred for the rest of the day patients are strongly advised not to drive home. The next day you can resume normal activities.  


What are the risks and complications of a laser iridotomy?

The most common complication is a rise in pressure shortly after the treatment. The pressure will be checked before you go home and if very high you will need extra treatment. There may be some temporary blurring of the vision. Bleeding in the eye is a known complication and may take a while to completely clear. Some patients may require a repeat treatment in the future. Rarely patients may get permanent halos or extra lines in their vision. Developing a cataract is also a rare complication.


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