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In acute angle-closure glaucoma cases, surgical iridectomy has been superseded by Nd:YAG laser iridotomy, because the laser procedure is much safer. Opening the globe for a surgical iridectomy in a patient with high intraocular pressure greatly increases the risk of suprachoroidal hemorrhage , with potential for associated expulsive hemorrhage .
A laser peripheral iridotomy (LPI) is the application of a laser beam to selectively burn a hole through the iris near its base. LPI may be performed with either an argon laser or Nd:YAG laser. [6] [7] There is currently no sufficient evidence to show any benefit on the use of iridotomy versus no iridotomy to slow down visual field loss.
A 2016 Cochrane Review sought to determine the effectiveness of YAG laser iridotomy versus no laser iridotomy for pigment dispersion syndrome and pigmentary glaucoma, in 195 participants, across five studies. [5] No clear benefits in preventing loss of visual field were found for eyes treated with peripheral laser iridotomy. [5]
Laser peripheral iridotomy has high efficacy in the treatment of pigmentary glaucoma. Argon laser trabeculoplasty is effective in the management of corticosteroid and pigmentary glaucoma. [ 2 ] However, this is often contraindicated due to high rates of failure in patients with uveitic glaucoma. [ 6 ]
The Nd:YAG laser is the most common laser used in laser designators and laser rangefinders. During the Iran–Iraq War, Iranian soldiers suffered more than 4000 cases of laser eye injury, caused by a variety of Iraqi sources including tank rangefinders. The 1064 nm wavelength of Nd:YAG is thought to be particularly dangerous, as it is invisible ...
If narrow angle glaucoma persists after iridotomy, it is called plateau iris syndrome and subsequently managed either medically (miotics) or surgically (laser peripheral iridoplasty). This condition is sometimes discovered after an iridotomy causes a rapid increase in eye pressure. [ 1 ]
Class 4 is the highest and most dangerous class of laser, including all lasers that exceed the Class 3B AEL. By definition, a class 4 laser can burn the skin, or cause devastating and permanent eye damage as a result of direct, diffuse or indirect beam viewing. These lasers may ignite combustible materials, and thus may represent a fire risk.
Refractive surgery is an optional eye surgery used to improve the refractive state of the eye and decrease or eliminate dependency on glasses or contact lenses.This can include various methods of surgical remodeling of the cornea (keratomileusis), lens implantation or lens replacement.