Selective Laser Trabeculoplasty
Laser surgery is often recommended before incisional surgery as an alternative to, or in conjunction with ocular medications, unless the eye pressure is very high or the optic nerve is badly damaged.
Selective laser trabeculoplasty (SLT) is an in-office procedure that reduces intraocular pressure in patients with glaucoma. The laser is applied through a special contact lens to the drainage system of the eye where it stimulates a biochemical change that improves the outflow of fluid from the eye.
SLT has been used since 1995 and has a proven track record for efficacy. On average, SLT can lower eye pressure by 20 to 30%. The laser is successful in about 80% of patients. In addition, studies have shown that SLT has a similar outcome compared to the most effective glaucoma eye drops. The treatment effect may last 3 to 5 years and SLT can be repeated when the original treatment effect diminishes.
Usually, eye drops are offered before laser for initial treatment of glaucoma. This stems from the era prior to SLT when laser trabeculoplasty was a relatively riskier procedure. Argon laser trabeculoplasty (ALT), the predecessor of SLT, delivered significantly higher laser energy to the eye resulting in structural damage and higher complication rates. By comparison, SLT has an improved safety profile where complications are typically infrequent, mild and short-lived.
Although uncommon, side effects such as a “pressure spike” or inflammation can usually be successfully treated with a short course of medication.
Laser Iridotomy
Laser peripheral iridotomy is a minimally invasive surgical procedure that creates a small opening (iridotomy) in the iris using a laser. It is performed in cases of narrow or closed angle glaucoma, or for eyes at risk of those conditions.
The angle is the space between the clear part of the eye (cornea) and the colored part (iris), close to their meeting point near the edge of the iris. It contains the trabecular meshwork ™, which is the main structure that directs fluid out of the eye.
In closed angle glaucoma, the angle is closed in many or most areas, causing increased eye pressure, which leads to optic nerve damage, and possible vision loss. This rise in eye pressure may occur suddenly (an acute attack of angle closure) or gradually.
Yag Laser Capsulotomy
Yag capsulotomy is a special laser treatment used to improve your vision after cataract surgery. It is a quick and painless, commonly performed procedure which is very safe. It is used to treat posterior capsular opacification which occurs behind the intraocular lens that was implanted during cataract surgery.
Transscleral Cyclophotocoagulation
Transscleral Cyclophotocoagulation (TCP) laser surgery is a popular minimally invasive treatment for glaucoma. TCP reduces the amount of fluid produced in the eye, thereby lowering the introcular pressure. TCP is performed as an outpatient procedure and the eye is often numbed with an injection of local anesthetic prior to the procedure. There are two types of Transscleral Cyclophtocoagulation:
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• Traditional Transscleral Cyclophotocoagulation
• Micropulse Laser Cyclophotocoagulation
Your doctor will decide which is best suited for you depending on the type and degree of glaucoma.