Laser Iridotomy
Laser iridotomy is performed on an outpatient basis with the Nd:YAG laser.
It is usually recommended preventively for eyes with narrow angles to avoid acute glaucoma due to pupillary block. In addition, it is very effective in treating acute glaucoma attacks.
The laser creates a small opening in the periphery of the iris, which establishes an alternative route for the aqueous humor trapped in the posterior chamber to pass into the anterior chamber. This allows the iris to recede, stop blocking the trabecular meshwork, and balance the pressures between the two chambers.
Laser Trabeculoplasty
Laser trabeculoplasty is a technique in which laser energy is applied to the trabecular meshwork in the form of separate impacts, usually covering half of the angle (180°) in each treatment, with the goal of increasing the outflow of aqueous humor and thus lowering intraocular pressure.
Patients who do not tolerate or do not adhere to initial medical treatment, if an open angle is detected through gonioscopy, may be candidates for laser trabeculoplasty. In addition, it is often performed when topical treatment for intraocular pressure is not effective or when the patient cannot undergo surgery. In some cases, it is indicated as an initial treatment for glaucoma.
Transscleral Cyclophotocoagulation
Transscleral cyclophotocoagulation with diode laser is a surgical procedure. The laser is applied in the operating room to the area of the eye that produces the aqueous humor (ciliary body) to decrease fluid production and therefore reduce intraocular pressure.
Cycloablation is indicated to reduce intraocular pressure in eyes with low visual potential, with pain, or in patients who are poor candidates for incisional surgery.
It is a quick and effective procedure in suitable cases.