Glaucoma is a serious eye condition that can lead to blindness if left untreated. One of the most common treatments for glaucoma is laser surgery. Having to undergo laser surgery for glaucoma may sound scary, but in the hands of an experienced ophthalmologist, the associated risks are relatively low. Let’s take a look at the pros and cons of the specific types of laser surgery for glaucoma.
Iridotomy Laser For Glaucoma: Pros And Cons
Some patients have an anatomically narrow angle. This means that the drainage system of the eye is not as open as it should be. Because of the narrow angle, the outflow of fluid can be restricted and this can cause the pressure in the eye to go up. An iridotomy is a glaucoma laser where a very small hole is created in your iris with a laser. This helps fluid to flow and drain out of the eye.
Pros Of Iridotomy Laser
1. This glaucoma laser procedure is done in the office by an ophthalmologist. You do not need to stay in the hospital for this. The benefit of this laser is that it can reduce a patient’s risk of developing acute angle closure glaucoma or damage from high pressure due to the narrow drainage system.
2. Laser iridotomy is generally well tolerated and has a quick recovery time. Most patients return to work the next day.
3. Covered by most insurance plans
Cons Of Iridotomy Laser
1. The risks or downside include inflammation and mild discomfort during and after the procedure.
2. Patients can experience high pressure after the procedure if some of the pigment released during it clogs the drainage system. In most cases this resolves with eye drops and time. In rare cases, patients may need more than just eye drops to lower the eye pressure.
3. If you do not have insurance, the laser can cost anywhere from $300 to $500 per eye.
If you have a very narrow angle, your doctor may recommend this laser procedure as a preventative measure to protect against an attack of acute angle closure glaucoma. In acute angle closure glaucoma, aqueous fluid inside the eye becomes stuck inside the angle of the eye (where the fluid drains), and this causes an increase in eye pressure which leads to vision loss. In this case, you may need to have the laser done emergently which is always harder to do since the eye is inflamed. Always discuss any questions or concerns you may have with your ophthalmologist.
SLT Laser Or Selective Laser Trabeculoplasty: Pros And Cons
An SLT laser or Selective Laser Trabeculoplasty can be an effective way of reducing your eye pressure. The laser targets a part of the eye called the trabecular meshwork. This type of laser eye surgery is done for open angle glaucoma and is not done in cases where a patient has very narrow angles. In the case of a very narrow angle, eye surgeons will usually suggest an iridotomy.
Pros Of SLT
1. The procedure is done under outpatient conditions and patients can usually return to work the next day.
2. SLT is usually painless and has a quick recovery time. Most patients return to work the next day.
3. It is covered by most insurance plans.
4. It can be repeated. If the SLT laser was effective in lowering your eye pressure the first time, your ophthalmologist may consider repeating it in the future to lower your pressure again.
Cons Of SLT
1. The procedure may cause some temporary light sensitivity and blurred vision.
2. Sometimes, patients can experience high pressure after the procedure. In the vast majority of cases, this is not a long-term problem and the pressure goes down after a few hours with eye drops. In very rare cases you may need surgical intervention to lower the eye pressure.
3. If you do not have insurance the procedure can cost anywhere from $300 to $500 per eye.
4. It may not work. SLT laser is effective in most patients but in 10 to 15% of patients the procedure may not work and you may need to use eye drops to lower your eye pressure.
Drops are usually as effective as SLT so the decision to choose between the two should be discussed with your ophthalmologist.
Choosing An Ophthalmologist For Eye Laser
Choosing a laser surgeon for glaucoma can be a difficult decision. There are many factors to consider, including surgeon training and experience, and your personal preference as a patient. In general, laser surgery for glaucoma can be a highly effective treatment option for many patients, but it is important to weigh the pros and cons carefully before deciding to undergo the procedure. If you have been diagnosed with glaucoma or a risk factor for glaucoma like having an anatomically narrow angle, it is important to work closely with your ophthalmologist to determine the best course of treatment for your individual needs.