Effective Glaucoma Laser Treatment Options

Key Highlights

• Glaucoma laser treatment effectively lowers eye pressure and manages glaucoma
• Laser trabeculoplasty, cyclophotocoagulation, and iridotomy are 3 common types
• These procedures are generally safe and have a low risk of complications
• It is crucial to consult an experienced ophthalmologist to determine the best treatment
• Understanding the procedure and aftercare is vital for successful treatment outcomes

Introduction

Glaucoma patients sometimes require laser treatment to lower intraocular pressure (IOP) or prevent IOP spikes. According to the National Eye Institute, reduction in eye pressure is the only treatment that has been proven to slow or stop the progression of glaucoma. This section will look at the different types of laser treatment for glaucoma. It will share the benefits, risks, and what to expect during and after the procedure. By understanding these points, patients can make better choices about their eye health.

Understanding Glaucoma and Laser Treatment

Glaucoma is an eye problem where the optic nerve degenerates causing loss of peripheral, then central vision. High eye pressure is a major risk factor for glaucoma. However, glaucoma can occur with eye pressures of 21 or less (classically, 21 or less is considered normal). This is called low tension or normal tension glaucoma.

The trabecular meshwork is the primary drainage region of the eye and allows drainage of aqueous fluid to maintain IOP at a normal level. When this meshwork is dysfunctional, fluid does not drain properly, causing a rise in pressure.

Laser treatment helps solve this problem by improving fluid flow through the meshwork or reducing fluid production from the ciliary body. By reducing the IOP, the optic nerve is protected from ongoing damage.

There are different types of lasers used in ophthalmology and some are specifically used to treat glaucoma. Knowing the type of glaucoma (i.e open angle glaucoma, chronic angle closure, or narrow angles) and the severity of the glaucoma is important for choosing the correct initial treatment to prevent loss of vision.

The Role of Laser Treatment in Managing Glaucoma

Laser treatment for glaucoma helps to lower eye pressure or prevent a rapid rise in the eye pressure in the case of narrow angles. This is important because it can prevent or slow down damage to the optic nerve.

Unlike traditional incisional surgery, laser procedures are less invasive. Most of them can be completed in our office, but one of them is performed in the operating room.

These treatments are a safe and effective option for patients who find it hard to use eye drops, face side effects, or do not respond well to medications.

Laser treatment, specifically SLT, can be used as the first option for treating open-angle glaucoma. An important glaucoma laser trial proved that SLT may have multiple benefits over using eye drops.

The decision depends on the type of glaucoma, its stage, and the patient’s desire to have laser treatment instead of using drops. By focusing on specific areas of the eye that help with the drainage of fluid, like the trabecular meshwork, this laser procedure makes the eye’s natural drainage system work better.

How Laser Treatments Reduce Intraocular Pressure

Laser treatments for glaucoma use a focused laser beam. Some lasers are thermal, which means they make small burns or changes in tissue. Other lasers are cold lasers, which mean they stimulate tissue without thermal changes.

The ultimate goal is to reduce eye pressure. Different types of laser treatments work in different ways, as we’ll discuss later. As an initial example, selective laser trabeculoplasty (SLT) helps with drainage. It targets a part of the eye called the trabecular meshwork.

When the laser energy hits the trabecular meshwork, it causes changes that make it easier for fluid to flow. This allows more aqueous humor, the fluid in the eye, to drain.

Laser treatments help balance how much fluid flows out, but other laser treatments reduce the amount of fluid that is produced. Either lowers eye pressure and decreases the chance of optic nerve damage.

These treatments usually only require topical anesthesia with eye drops. However, one requires local anesthesia. Anesthetics help patients feel more comfortable.

3 Most Common Glaucoma Laser Treatment Options

Several laser treatments can help with glaucoma. The most common ones are selective laser trabeculoplasty (SLT), micro-pulse diode cyclophotocoagulation (MPC), and laser peripheral iridotomy (LPI). Each procedure works on a different part of the eye to lower eye pressure. Selecting the right treatment depends on the type of glaucoma and the needs of the patient:

• SLT is usually the first choice for open-angle glaucoma (primary, pigmentary, or pseudoexfoliation)
• MPC is more common for patients with advanced glaucoma or those who did not improve with other treatments
• LPI is mainly used to prevent angle closure for those with narrow angles or for intermittent or full angle-closure glaucoma

1.) Selective Laser Trabeculoplasty (SLT)

Selective Laser Trabeculoplasty (SLT) is a laser treatment for glaucoma. It focuses on the trabecular meshwork to lower eye pressure. The treatment uses a low frequency laser beam to affect specific cells.

Patients feel minimal discomfort during the procedure. SLT is done in the doctor’s office and is non-invasive unlike regular glaucoma surgeries. Patients can usually get back to their daily activities the same day.

Dr. Jones states, “SLT has become the definitive first-line treatment for open-angle glaucoma in Europe. There is a push to do the same in the United Sates, but as of today, drops and SLT are still both considered first-line treatment.”

2.) Micro-Pulse Diode Cyclophotocoagulation (MPC)

Micro-pulse diode cyclophotocoagulation (MPC) is a laser treatment that helps reduce intraocular pressure by lowering the production of aqueous humor. Unlike Selective Laser Trabeculoplasty (SLT), which focuses on the trabecular meshwork, MPC focuses on the ciliary body. This part of the eye is responsible for making aqueous humor. The treatment sends short bursts of laser energy to the ciliary body, decreasing how much fluid it produces.

Many doctors recommend MPC when traditional glaucoma surgeries seem too risky or have failed. It is a non-invasive option that can effectively lowers eye pressure. This makes it suitable for patients with advanced glaucoma, those not suitable for surgery, or anyone with specific types of glaucoma that don’t respond to other treatments.

MPC is different from other cyclodestructive methods because it uses the newest laser technology that delivers pulsed energy. This technique limits heat damage to nearby tissues and lowers the risk of complications.

It is performed with local anesthesia and IV sedation at the American Surgery Center, an outpatient surgery center.

3.) Laser Peripheral Iridotomy (LPI)

Laser peripheral iridotomy (LPI) is a straight forward procedure that can have a major impact in preventing a very dangerous form of glaucoma. It treats narrow angle or angle-closure glaucoma by making a tiny hole in the iris.

This small hole helps aqueous fluid flow from behind the iris into the anterior chamber. As a result, the iris lays flat, instead of bowing forward where it can obstruct the trabecular meshwork.

It is not intended to reduce pressure in narrow angle glaucoma, because the pressure typically is still normal. It is designed to prevent a rapid pressure rise in these cases.

If the angle is already closing, the IOP can be high and in these cases it can reduce IOP. Like SLT, this procedure is performed in our office. The procedure is fairly quick, and most patients feel very little discomfort.

LPI can prevent vision loss and lower the chance of optic nerve damage.

Risks of Laser Surgery

Laser surgery for glaucoma is usually safe and works well, but it can have risks and side effects like any surgery. It is discuss this with your ophthalmologist to help you choose the right treatment. Common risks and side effects of laser treatment include:

• Temporary blurry vision
• Eye irritation
• Inflammation and light sensitivity
• Short-term rise in eye pressure
• Failure to work
• Need for additional treatments

In rare cases, there can be more serious issues, like infection, bleeding in the eye, or vision loss. Again, these kinds of problems are extremely rare, especially when a skilled ophthalmologist like Dr. Jones performs the procedure.

To lower risks and get the best results, it is important to follow care instructions and return for your follow-up appointments.

Preparing for Your Laser Treatment in San Antonio

Before your laser treatment, you will have already consulted with your doctor in their office. During this time, you will discuss your medical history and check your eye condition. Together, you will choose the best laser procedure for you.

Your doctor will give you specific instructions based on your needs. This might include continuing your current glaucoma drop regimen and adding an anti-inflammatory drop for about 1 week after the treatment.

You will also have an opportunity to obtain more information about the procedure and ask any questions. This will include what to expect before, during, and after the treatment.

We have excellent videos about each of these procedures in our office and on our website. We can play them for you or you can watch them at your leisure on your own device.

If you have any questions or concerns, don’t be afraid to ask. Dr. Jones and Dr. Triana are here to help you feel comfortable and ready to take charge of your glaucoma!

What to Expect Before the Procedure

On the day of your laser treatment, get to your appointment on time. Remember, SLT and LPI treatments are done at the office, and MPC is performed at the American Surgery Center. Arriving on time will give you an opportunity to complete any paperwork.

You may receive numbing eye drops. These will help reduce discomfort during the procedure. Your doctor might also use special eye drops to dilate your pupil (LPI) or constrict your pupil (SLT) in the eye being treated.

After a brief waiting period, you will sit in front of the laser machine. Dr. Jones will carefully place a special lens on your eye. This lens helps to focus the laser beam exactly on the area that needs treatment. The actual procedure is usually quick. It lasts from just a few minutes to around 15 minutes, based on the type of laser treatment you are having.

MPC is also a fairly quick procedure. It does take longer overall due to the fact that your eye is put asleep with a nerve block prior to the treatment. Don’t worry though, our anesthesiologist will give you some sedating medication that allows you to fall asleep for a few minutes so that the nerve block can be delivered in comfort.

How to Choose the Right Specialist in Texas

Choosing the right glaucoma specialist is very important for getting the best results from your laser treatment. You should look for an ophthalmologist who has lots of experience with glaucoma and laser procedures, especially the type of laser treatment you need. Dr. Jones is fellowship-trained in glaucoma at the Massachusetts Eye & Ear Infirmary, the ophthalmology program of the Harvard Medical School. He’s been trained by some the world’s best glaucoma specialists!

Aftercare and Monitoring Post-Laser Treatment

After your laser treatment, it is important to take good care of your eyes. This will help you heal well and increase your chances of good long-term results. Dr. Jones will give you specific instructions. These will include information about your eye drop schedule, if there is anything you should avoid, and when to come back for check-ups.

These steps are personalized just for you. By attending your follow-up appointments as scheduled, your doctor can see how you are doing, make changes to your treatment if needed, and keep track of your laser treatment’s long-term effects.

Short-Term Aftercare Tips

Right after the procedure, you may feel some minor discomfort. This could be a slight scratching feeling, light sensitivity, or blurry vision. These effects usually go away within a few days. It is very important not to rub your eyes. Rubbing can irritate the area and increase the risk of infection.

You will be prescribed eye drops to help with inflammation. Use the eye drops as directed by your doctor. You can wear sunglasses for light sensitivity. If you have pain, you can use an ice pack over your closed eyelid and take over-the-counter pain relievers, if you don’t have any allergies or contraindications.

You can resume your daily activities again slowly. Avoid strenuous activities, heavy lifting, and swimming for one week or until you have completed your anti-inflammatory drops.

Long-term Benefits of Glaucoma Laser Surgery

Glaucoma laser surgery has many long-term benefits according to the American Academy of Ophthalmology. It can greatly improve your quality of life. One big benefit is that it may reduce or in some cases, stop the need for daily glaucoma eye drops. This makes life easier and helps you stick to your treatment better.

Also, laser surgery helps lower eye pressure. This can prevent additional vision loss and protect your remaining vision. By slowing down glaucoma, this treatment helps you remain independent, enjoy your hobbies, and live well.

Conclusion

In conclusion, glaucoma laser treatments can be a good way to manage intraocular pressure and help maintain your vision for years to come. Knowing how laser treatments work and what options you have can help you make smart choices for your eye care. There are risks with laser surgery, but taking the right steps for preparation and aftercare can improve the results. If you’re thinking about having glaucoma laser treatment in San Antonio, it is important to pick an ophthalmologist who is fellowship-trained in glaucoma and follow their advice.

For more details or to set up a consultation, please reach out to us @ (210) 485-1488.

Frequently Asked Questions

How long does the effect of glaucoma laser treatment last?

The success of glaucoma treatment can vary in each individual. How long it works depends on what kind of laser treatment you get, how bad your glaucoma is, and how well you respond to the treatment.

Some people may see lower eye pressure for many years. Others might need more treatment sooner. It is important to have follow-up appointments to check how well the treatment is working.

Can laser treatment completely cure glaucoma?

Sadly, there is NO CURE for glaucoma at this time. Also, laser therapy cannot fully fix the harm already done to the nerve by the disease. But, laser treatment is a useful way to manage it. It helps lower eye pressure, slow the disease down, and can save your vision.

It’s important to have realistic expectations when undergoing any procedure, even non-invasive laser procedures.

Are there any risks or side effects associated with glaucoma laser treatment?

While glaucoma laser treatment is generally safe, some risks and side effects may include temporary vision issues, increased eye pressure, or inflammation. Although extremely rare, more serious complications like retinal detachment or infection could occur. It’s important to discuss these risks with your eye care provider before undergoing the treatment.