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Laser iridotomy (YAG laser iridotomy)

Laser iridotomy is used to treat or to prevent a certain type of glaucoma called narrow angle glaucoma. In this condition, the drainage of fluid from within the eyeball to the blood system is impaired because the front compartment of the eye is unusually shallow. A laser iridotomy makes a very small hole in the iris (the coloured part of the eye). This can deepen the front compartment allowing the fluid to escape from the eye more freely reducing the pressure in the eye. It can also prevent attacks of severe glaucoma in the future.

What can I expect at the time of treatment ?

The treatment is carried out in the outpatient department and takes a few minutes. Your pupil may have been made smaller using drops. Your doctor will then insert some anaesthetic drops into the eye. These may sting for a few seconds. A contact lens is then placed on the eye and this allows the doctor to focus the laser beam on the iris. You will then hear some clicks and beeps of the machine when the laser fires. The procedure is not usually painful but it can make you jump and may feel like a small pinch. Usually only a few shots are needed to make the iridotomy. It is important to try to keep still during the procedure and to try not to jump after the laser fires. After the procedure, the doctor may put some drops into the eye and you are then free to go home. It is important not to drive to and from the hospital for this appointment because your vision may be affected by the drops and, for a short time, by the treatment. Your eye may feel numb for about 15 minutes but you may also feel as though the contact lens is still in place. Your doctor will have removed the contact lens and your eye will feel comfortable after an hour or so.

What are the side effects ?

The iris may be quite thick and difficult to perforate. You may require more than one treatment session if your iris has been difficult to complete at one attempt. Side effects are rare. A transient rise in pressure within the eye may occur but you may have been given drops to counteract this. You will be given a course of drops to take for about 2 weeks after the treatment to prevent inflammation. Very occasionally the eye becomes inflamed despite these drops. If the eye becomes red and painful after laser treatment you should contact the eye department without delay. It is possible that the vision becomes slightly worse after the procedure. This may be because pigment has been released into the front of the eye during the procedure. This usually settles over the first 24 hours. Long term visual loss is very rare. The development of cataract after laser iridotomy has been reported but this is also rare.

If you have any questions regarding this information, please ask your eye doctor.


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