Is There A Laser Surgery For Glaucoma Treatment?
Glaucoma is a chronic eye disease that causes progressive damage to the optic nerve. This damage occurs when the pressure inside the eye becomes too high for the optic nerve to tolerate. In many cases, treatment begins with prescription eye drops that lower pressure, followed by oral medication if necessary. Laser procedures play an important role in glaucoma management and offer an effective, minimally invasive option for lowering intraocular pressure in appropriate patients.
How Laser Treatment Works
Laser surgery for glaucoma does not remove tissue in the same way that laser procedures for refractive error do. Instead, the laser creates controlled changes in either the drainage angle or the ciliary body depending on the specific type of glaucoma and the selected procedure. By improving the flow of aqueous fluid or reducing fluid production, laser treatments help reduce intraocular pressure. Lowering pressure is the only proven method of preventing or slowing optic nerve damage.
Laser treatment is typically performed in an outpatient setting. The procedure is done with topical anesthesia, and patients usually tolerate it well. Vision is not corrected by this type of laser surgery. Rather, the goal is long-term pressure reduction.
Selective Laser Trabeculoplasty
Selective laser trabeculoplasty is one of the most commonly used laser procedures for open-angle glaucoma. It targets the trabecular meshwork, which is the primary drainage pathway inside the eye. Over time, this drainage tissue may become less efficient, leading to elevated pressure. Selective laser trabeculoplasty uses low-energy laser pulses that trigger a biological response within the tissue. This response improves fluid outflow without causing thermal damage to surrounding structures.
Selective laser trabeculoplasty can be performed as either a first-line treatment or as an adjunct to medication. Many patients continue to use eye drops after the procedure, but some may reduce their medication burden. The effect of selective laser trabeculoplasty can last several years. If pressure begins to rise again, the procedure can often be repeated, depending on the condition of the drainage tissue.
Laser Peripheral Iridotomy
Laser peripheral iridotomy is used for angle-closure glaucoma or eyes that are at risk for angle closure. In these eyes, the drainage angle between the iris and the cornea becomes narrow or blocked. This obstruction prevents aqueous fluid from accessing the trabecular meshwork. Laser peripheral iridotomy creates a small opening in the outer edge of the iris. This opening allows fluid to flow more freely, reducing pressure and preventing the risk of sudden acute angle closure.
Laser peripheral iridotomy is often recommended for patients with narrow angles before symptoms occur. In cases of acute angle closure, it is used to quickly restore fluid movement after pressure has been brought under control with medication. Some patients may still require additional treatment after the procedure if the angle remains narrow or if pressure does not normalize.
Recovery And Follow-Up After Laser Treatment
Recovery after glaucoma laser surgery is generally straightforward. Most patients can resume normal activities shortly after the procedure. Temporary redness, light sensitivity, or mild discomfort may occur but typically improves within a day or two. Eye pressure is checked soon after the procedure to ensure that it has responded appropriately. Some patients may require anti-inflammatory drops for a short period.
Laser treatment is not a cure for glaucoma. Ongoing monitoring is essential because pressure can rise again even after a successful procedure. Patients should continue regular eye exams and visual field testing to track optic nerve health.
When Laser Treatment Is Recommended
Laser surgery may be recommended when glaucoma medications do not sufficiently lower pressure, cause side effects, or are difficult for the patient to use consistently. It is also an option as a first-line therapy in certain cases of open-angle glaucoma. For narrow-angle glaucoma, laser peripheral iridotomy is often necessary to prevent sudden pressure elevation.
The decision to use laser treatment depends on the type of glaucoma, the severity of optic nerve damage, the patient’s response to other treatments, and the structure of the drainage angle. An ophthalmologist evaluates each of these factors before determining whether laser therapy is appropriate.
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