Laser Iridotomy

Learn more about YAG laser iridotomy at King Edward VII’s Hospital

Why would I need a laser iridotomy procedure?

Some patients with a type of glaucoma called acute angle closure glaucoma, or those who are at risk of developing the condition, may require a laser iridotomy procedure. It can also be used for patients with acute or chronic angle closure glaucoma. It can be used on patients with chronic closed or narrow angle glaucoma.

Glaucoma is damage to the optic cause by an abnormal pressure in the eye, called intraocular pressure, which results in some level of sight loss.

In cases of acute angle closed glaucoma, this damage is caused by an increase in the fluid in the eye due to a blockage in the flow of the watery fluid in the eye called the aqueous humour.

Laser Iridotomy is a procedure that creates a small hole in the iris, allowing the fluid trapped behind the iris to pass through and drain properly, which reduces the pressure in the eye.

What symptoms does a laser iridotomy procedure address?

A laser iridotomy procedure aims to reduce the fluid build-up caused by acute angle closed glaucoma. During the procedure, a targeted laser is used to make a small hole in the part of the eye called the iris through which fluid can flow into the front chamber of the eye, reducing the intraocular pressure.

When should you speak to your specialist about a laser iridotomy procedure?

If you have glaucoma, your glaucoma appears to be getting worse or you’re concerned that you might be developing acute angle closure glaucoma, speak to your GP, Optician or Ophthalmologist, as soon as possible about being referred for a laser iridotomy procedure.

How is a laser iridotomy procedure performed?

Unless otherwise directed, continue to use any eye drops or medications that you’ve been prescribed for your glaucoma, including on the day of your procedure.

You will have your vision and intraocular pressure checked. Your surgical team will then add a series of drops to your eyes to help prevent the pressure within your eye increasing, to constrict, or decreasing the size of your pupils and to numb your eyes.

A gel will then be applied to your eyes in order to place a special contact lens over the eye. You will be asked to sit at a machine that looks very similar to one used during routine eye tests. Your consultant will then use a laser to treat your eye. During this time, you may experience some discomfort, but it should only last for a short period

A laser iridotomy procedure takes a few minutes, but your whole appointment may be a few hours. Most patients are able to return home the same day.

What is the recovery like for a laser iridotomy procedure?

Your recovery from a laser iridotomy procedure will depend on multiple factors, including your age, fitness level and the nature of your procedure.

Within 30 minutes after your procedure, your vision and intraocular pressure will be checked again (if this remains high, it will be checked again later). Most patients experience blurred vision for a few hours and some experience slight bleeding inside the eye. You may feel slight discomfort, but you will be provided with eye drops to help keep inflammation to a minimum. Paracetamol can be helpful if you feel any discomfort in the days following your procedure.

You will be advised not to drive home after your procedure, and your medical team will arrange a follow up appointment within a few weeks.

Some patients may experience problems with glare and it’s important to mention this to your consultant if this happens to you.

Are there any risks/complications associated with a laser iridotomy procedure?

As with any medical procedure, it’s possible for risks or complications to arise. Speaking with your specialist or surgeon beforehand will help you avoid any adverse reactions.

A laser iridotomy procedure has a relatively low risk of serious complications, but the following risks and complications can occur in a small number of cases:

● Pain
● Blurred vision
● A gritty eye
● Bleeding in the front of the eye
● Mild inflammation
● Raised intraocular pressure
● Visual disturbances such as haloes and ghosting

How can I prepare for a laser iridotomy procedure?

Prior to a laser iridotomy procedure, your surgeon will discuss with you how best to prepare, as each patient is different with differing needs.

Common preparations for a laser iridotomy procedure include:

● Routine blood tests and scans of the front or back of the eye as requested by your surgeon

Are there alternatives for a laser iridotomy procedure?

Many patients may benefit from eye drops to reduce the pressure in the eye. An alternative to laser iridotomy is surgical iridectomy where an incision is made to remove part of the iris, but this procedure is higher risk than laser iridotomy. Your consultant with advise you on the best course of action for you.