The Dean McGee Eye Institute (DMEI) boasts state-of-the-art surgical lasers, plus a team of professionals focused solely on eye surgery. Laser Iridotomy surgery, a common procedure used to help relieve eye pressure caused by glaucoma, is one of the many cutting-edge procedures we can provide. DMEI glaucoma specialist, Ben J. Harvey, MD, talks us through exactly what laser iridotomy surgery is and how it’s used to treat DMEI’s glaucoma patients.
What Is Laser Iridotomy Surgery?
Laser iridotomy, also called laser peripheral iridotomy (LPI), is a method by which ophthalmologists create a microscopic hole in the iris using a laser to open the angle (or internal drainage system of the eye) in patients with narrow or closed angles. This improves the drainage of the aqueous eye fluid and decreases intraocular pressure to prevent damage to the optic nerve and the loss of vision or blindness that can result.
“In patients with narrow angles, the periphery of the iris may come in close contact with structures in the angle, most notably the trabecular meshwork, the filter through which the fluid in the front part of the eye drains to reach the venous system,” Dr. Harvey says.
Risk factors for angle-closure include Asian ancestries, eyes that are shorter than average, female gender, family history, and hyperopia or farsightedness.
Additionally, LPI is used to treat acute angle-closure, a medical emergency in which there is a sudden, complete obstruction of the drainage angle of the eye that can cause a rapid onset of intraocular pressure. This sudden increase in pressure can cause blindness in a matter of hours, however, it can be prevented or terminated by LPI.
Symptoms of acute angle-closure may include:
Nausea and vomiting
This procedure may also be performed on other, less common disorders affecting the iris.
Frequently Asked Questions About Laser Iridotomy
How Is Iridotomy Surgery Performed?
When performing this laser treatment, the patient’s eye is first anesthetized with topical drops or gel followed by the application of a special contact lens that allows the ophthalmologist to focus clearly on the peripheral iris where the laser is applied.
“The procedure is performed in-office and takes approximately five minutes to complete. I usually perform LPI at least once per week,” Dr. Harvey says.
Is Laser Iridotomy Painful?
“Most patients report the procedure is not overtly painful and is tolerable. The sensation is usually described as a ‘popping’ or ‘electrical sensation,” Dr. Harvey says. Can You Drive After Laser Iridotomy?
The eye(s) may be blurry for a short period following LPI, so we usually recommend patients bring a driver on the day of the procedure.
What’s the Success Rate of LPI?
Success with laser peripheral iridotomy can be assessed in different ways according to Dr. Harvey
“When considering our ability to achieve a patent hole in the peripheral iris, we are almost always successful; however, our ability to open the angles varies. Some studies state one-third to one-half of angles remain closed after LPI; however, we do know it significantly reduces the risk of acute angle-closure.”