Laser Surgery for Glaucoma

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Laser treatment for open angle glaucoma
Open angle glaucoma may be treated with a laser in an attempt to lower the pressure inside the eye (• See Photo). The newest and most gentle type of laser is the Selecta Selective Laser Trabeculoplasty, or SLT for short. This treatment usually involves minimal discomfort, and is completed in less than thirty minutes. It is usually performed in the office with topical anesthetic drops. The laser is attached to a machine that is similar to the one that your eye doctor uses to examine your eyes. During the laser procedure, the patient sees multiple bright flashes of light, and may occasionally feel a mild stinging sensation in the eye. Usually, however, no pain is experienced by the patient.

In laser treatment for open angle glaucoma, the laser beam is directed towards the drainage area of the eye, which is called the trabecular meshwork (• See Photo). This is in the front part of the eye between the cornea and the iris. In some types of glaucoma, there is an invisible blockage in the trabecular meshwork which blocks the outflow of fluid, thereby increasing the pressure inside the eye. It has been discovered that treating the trabecular meshwork with a laser can lower the intraocular pressure. It is thought that the laser increases the flow of fluid through this drain (• See Photo).

This laser is generally effective in about eighty percent of patients who undergo the procedure. Sometimes the beneficial effect of the laser is not permanent. In approximately fifty percent of patients, the laser helps to lower pressure for as long as ten years.

Many times, your ophthalmologist will treat only one half of the drainage area with the laser treatment. One reason for this is to decrease the risk of possible complications from the laser. Possible complications include an actual increase in the eye pressure, or inflammation inside the eye. These two complications are normally treated with eye drops. If treatment of one half of the drainage area works to lower the pressure, then treatment to the other half of the drainage area can be performed at a later date if the eye pressure rises again.

After laser treatment for open angle glaucoma, the complete effect may not be noticed until about six weeks after the procedure. Glaucoma medications should be continued following laser treatment unless your eye doctor instructs you otherwise.

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