The type of laser surgery will depend on the form of glaucoma and how severe it is. Lasers produce a focused beam of light that can make a very small burn or opening in your eye tissue, depending on the strength of the light beam. Laser surgeries are performed in an outpatient setting in your doctor’s office or in a hospital clinic.
During the laser surgery, the eye is numbed so that there is little or no pain. The eye doctor then holds a special lens to the eye. The laser beam is aimed into the eye, and there is a bright light, like a camera flash.
The following are the most common laser surgeries to treat glaucoma.
Selective Laser Trabeculoplasty (SLT)
For the treatment of primary open-angle glaucoma (POAG).
SLT uses a laser that works at very low levels. It treats specific cells “selectively,” leaving untreated portions of the trabecular meshwork intact. For this reason, SLT may be safely repeated.
SLT may be an alternative for those who have been treated unsuccessfully with ALT or pressure-lowering drops.
Argon Laser Trabeculoplasty (ALT):
For the treatment of primary open-angle glaucoma (POAG).
The laser beam opens the fluid channels of the eye, helping the drainage system work better. In many cases, medication will still be needed.
Usually, half the fluid channels are treated first. If necessary, the other fluid channels can be treated in a separate session another time. This method prevents over-correction and lowers the risk of increased pressure following surgery.
Argon laser trabeculoplasty has successfully lowered eye pressure in up to 75% of patients treated.
Laser Peripheral Iridotomy (LPI)
For the treatment of narrow angles and narrow-angle glaucoma.
Narrow-angle glaucoma (also known as angle-closure glaucoma) occurs when the angle between the iris and the cornea in the eye is too small. This causes the iris to block fluid drainage, increasing inner eye pressure. LPI makes a small hole in the iris, allowing it to fall back from the fluid channel and helping the fluid drain.
Laser Cyclophotocoagulation
An alternative to filtering microsurgery that is typically used later in the treatment algorithm. Several different types of lasers can be used to hamper the ciliary body’s ability to make fluid and, thus, lower the eye pressure. The procedure may need to be repeated in order to permanently control glaucoma.
Pain or Discomfort from Glaucoma Laser Surgery
There is a slight stinging sensation associated with LPI and ALT. In YAG CP laser surgery, a local anesthetic is used to numb the eye. Once the eye has been numbed, there should be little or no pain and discomfort.
Long-term Benefits of Glaucoma Laser Surgery
Glaucoma laser surgeries help to lower the intraocular pressure (IOP) in the eye. The length of time the IOP remains lower depends on the type of laser surgery, the type of glaucoma, age, race, and many other factors. Some people may need the surgery repeated to better control the pressure IOP.
Medication Following Laser Surgery
In most cases, medications are still necessary to control and maintain eye pressure. However, surgery may lessen the amount of medication needed.
Recovery Time
In general, patients can resume normal daily activities the next day after laser surgery.
The procedure is usually performed in an eye doctor’s office or eye clinic. Before the surgery, your eye will be numbed with medicine. Your eye may be a bit irritated and your vision slightly blurry after the surgery. You should arrange a ride home after your surgery.
Risks of Laser Surgery
As with any type of surgery, laser surgery can carry some risks. Some people experience a short-term increase in their intraocular pressure (IOP) soon after surgery. In others who require YAG CP (Cyclophoto-Coagulation) surgery, there is a risk of the IOP dropping too low to maintain the eye’s normal metabolism and shape. The use of anti-glaucoma medication before and after surgery can help to reduce this risk.
Increased Risk of Cataracts
There is a small risk of developing cataracts after some types of laser surgery for glaucoma. However, the potential benefits of the surgery usually outweigh any risks.
There is a common myth that lasers can be used to remove cataracts; this is not the case except in experimental studies. After a cataract has been taken out with conventional cutting surgery, there often remains an outer membrane lens capsule. This membrane can slowly thicken and cloud vision, just as the cataract did. Laser surgery can open this membrane, helping to clear vision without an operation. This laser procedure is called a capsulotomy.
It is important to discuss all of your questions or concerns about laser surgery with your eye doctor.
Last reviewed on March 16, 2022
