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In acute angle-closure glaucoma cases, surgical iridectomy has been superseded by Nd:YAG laser iridotomy, because the laser procedure is much safer.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.
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]
Computational fluid dynamics (CFD) simulations have shown that an optimal iridotomy size to relieve the pressure differential between the anterior and posterior side of the iris is around 0.1 mm to 0.2 mm. [78] This coincides with clinical practice of LPI where an iridotomy size of 150 to 200 microns is commonly used. However, larger iriditomy ...
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.
Photodisruption is a form of minimally invasive surgery used in ophthalmology, utilizing infrared Nd:YAG lasers to form plasma ("lightning bolt"), which then causes acoustic shock waves ("thunderclap") which then in turn affects tissue.
Trabeculoplasty is a laser treatment for glaucoma. It is done on an argon laser equipped slit lamp, using a Goldmann gonioscope lens mirror. Specifically, an argon laser is used to improve drainage through the eye's trabecular meshwork, from which the aqueous humour drains. This helps reduce intraocular pressure caused by open-angle glaucoma. [1]
The procedure results in a decrease in nearsightedness. According to the PERK study, 58% of eyes were corrected within 1.00D of goal 3 years after surgery. Additionally, 76% of eyes had uncorrected vision of 20/40 or better at 3 years. [5] From 2 to 10 years post-operatively 43% of eyes had an increase in farsightedness by 1.00D or more.