Laser treatment of glaucoma

Glaucoma is an extremely difficult eye condition. Typically, it is chronic and progressive in nature. This disease represents the second leading cause of blindness in the globe. It manifests in various ways and, if not detected in a timely manner, can cause severe and irreversible damage in a subtle and quiet manner. An injury capable of causing blindness In particular, it is produced by a higher internal pressure than the eye can ordinarily withstand. The most revolutionary laser surgery for glaucoma is Selective Laser Trabeculoplasty (SLT), which has been accessible in World for the past 20 years but is still underutilized enough. In the event of closed-angle glaucoma, Yag Laser iridotomy or trabeculoplasty laser surgery are utilized to treat glaucoma. It can be used in a number of ways to avoid acute glaucoma in people with open-angle glaucoma.

laser glaucoma treatment
laser glaucoma treatment

Treatment of glaucoma using laser therapy

The laser is an intense and highly focused source of light that enables the development of novel and trustworthy therapeutic techniques. Moderately efficient, non-invasive approaches for glaucoma control Outpatient laser surgery is performed without the requirement for hospitalization. After a drop of anesthetic is administered, rendering the process painless, the patient sits and rests against the chin support (as in the slit lamp examination). After putting gel on the eye, a contact lens is put in, and laser treatment is given for a few seconds or minutes, depending on the type of laser and the treatment being done.

In certain instances, glaucoma can be successfully cured using laser therapy. There are a variety of laser therapy types, each with its own indications and contraindications. Consequently, it is essential to precisely identify patients who may benefit from various forms of treatment. Laser therapy tries to control intraocular pressure by reducing or getting rid of the need for eye drops that cause irritation or by avoiding or putting off surgery.

Laser selective trabeculoplasty (SLT)

What is SLT, or Selective Laser Trabeculoplasty?

SLT, also known as Selective Laser Trabeculoplasty, is a simple yet highly efficient technique for lowering intraocular pressure in glaucoma patients. Glaucoma-STL is a gentle alternative to traditional glaucoma treatment. It takes less than five minutes for your eye doctor to do in their office.

The purpose of trabeculoplasty, a type of laser surgery for glaucoma, is to facilitate the drainage of aqueous fluid from the eye. This reduces the eye’s pressure.

This procedure treats the iridocorneal angle at the level of the trabeculae. Using specialized gonioscopic angle lenses, laser points should be focused at the junction of pigmented and nonpigmented trabeculae. The decrease in intraocular pressure (IOP) is caused by the laser’s mechanical and biological effects. This type of laser is used to treat high-risk cases of primary open-angle glaucoma, pigmentary glaucoma, pseudoexfoliative glaucoma, and ocular hypertension.

Laser therapy at the angle of the iridocornea

There are various laser types that can be used for this purpose: In the past, argon laser (argon laser trabeculoplasty, ALT) was utilized. However, YAG laser is now the method of choice (selective laser trabeculoplasty, SLT). The YAG laser only hits the pigmented cells of the trabeculae, so it doesn’t hurt many of the other structures around it.

laser glaucoma treatment surgery
laser glaucoma treatment surgery

Iridotomy

Aqueous humor is created by the ciliary body and flows through the pupillary foramen from the posterior chamber (behind the iris) to the anterior chamber of the eye (in front of the iris). By way of the trabeculae and Schlemm’s canal, it then enters the main circulation. In angle-closure glaucoma, the increased pressure in the posterior chamber pushes the iris forward, obstructing the trabeculae. Iridotomy has a therapeutic impact on lowering intraocular pressure in cases of narrow-angle glaucoma and acute glaucoma, as well as in some cases of mixed glaucoma and phacomorphic glaucoma with pupillary block. Patients with an occluded angle or a closed angle of more than 180 degrees can be kept from getting acute or long-term corner closure.

Typically, laser iridotomy is performed peripherally so that the upper iris can be concealed by the upper eyelid. In certain instances, two supero-lateral punctures may be indicated. Occasionally, multiple types of lasers (argon or yag) can be combined. The choice of laser type is influenced by the iris’s color and thickness. The iridotomy should be sufficiently large to keep the eye open even if the iris swells, the pigment epithelium expands, or the pupil becomes larger.

Iridoplasty by a laser

Iridoplasty is performed by arranging laser spots in a ring within the peripheral iris to detect a superficial scar that narrows the iris stroma and enlarges the iridocorneal angle. The actual principle is to open the circumferential corner to limit the possibility of corner closure. This treatment is indicated in situations of plateau iris, in anticipation of laser trabeculoplasty in patients with narrow-angle glaucoma, and in patients with narrow-angle glaucoma who do not react to pharmacological therapy and cannot have peripheral iridotomy (e.g. due to the presence of corneal edema). On the other hand, iridoplasty is not a good idea if the iris is flat or if there is a lot of anterior peripheral synechia.

The process involves creating four to ten scars per major quadrant (200–500 microns). Postoperative patient, temporary elevation in intraocular pressure It must be monitored for occupational purposes and has a moderate risk of iritis. In very rare cases, this treatment could cause the iris to thin and the pupils to get bigger.