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Writer's pictureMr Ahmad Elsahn

Exploring the Spectrum of Laser Treatments for Glaucoma

Updated: Sep 14

Glaucoma, a group of eye conditions that can lead to vision loss and blindness, often necessitates timely and effective intervention to manage intraocular pressure (IOP). Laser treatments have emerged as vital tools in the glaucoma management arsenal. Each laser procedure offers unique benefits and targets specific types of glaucoma or stages of the disease. In this blog post, we’ll explore four different laser options: Selective Laser Trabeculoplasty (SLT), YAG Laser Iridotomy, Excimer Laser Trabeculostomy (ELT), and Diode Laser Cycloablation.


Close-up of an eye undergoing laser treatment for glaucoma

1. Selective Laser Trabeculoplasty (SLT)


Overview:

Selective Laser Trabeculoplasty is primarily used to treat open-angle glaucoma. It enhances the outflow of aqueous humor through the trabecular meshwork, effectively lowering IOP.


Procedure:

  • Preparation: The eye is numbed with anesthetic drops.

  • Laser Application: Low-energy laser pulses are applied to the trabecular meshwork.

  • Duration: Typically takes about 10 minutes per eye.

  • Recovery: Patients can usually resume normal activities almost immediately.


Benefits:

  • Safety: Minimal risk of side effects due to the selective nature of the laser.

  • Efficacy: Can significantly lower IOP, with effects lasting up to six years.

  • Convenience: Reduces or eliminates the need for daily eye drops.


Ideal Candidates:

  • Patients with primary open-angle glaucoma.

  • Individuals seeking an alternative to daily medication.


2. YAG Laser Iridotomy


Overview:

YAG Laser Iridotomy is used primarily for narrow-angle or angle-closure glaucoma. It creates a small hole in the iris to improve the flow of aqueous humor, preventing the buildup of pressure.


Procedure:

  • Preparation: Anesthetic drops are used to numb the eye.

  • Laser Application: A focused YAG laser beam creates a tiny opening in the peripheral iris.

  • Duration: The procedure usually takes a few minutes.

  • Recovery: Patients may experience mild discomfort and blurry vision temporarily.


Benefits:

  • Preventative: Can prevent acute angle-closure glaucoma attacks.

  • Quick: The procedure is brief and typically done on an outpatient basis.


Ideal Candidates:

  • Patients with narrow-angle glaucoma or those at risk of angle-closure glaucoma.

  • Individuals who have experienced a sudden increase in IOP.


3. Excimer Laser Trabeculostomy (ELT)


Overview:

Excimer Laser Trabeculostomy is a newer laser treatment that creates small channels in the trabecular meshwork to enhance aqueous humor outflow. It is used for open-angle glaucoma.


Procedure:

  • Preparation: The eye is anesthetized.

  • Laser Application: The excimer laser creates micro-channels in the trabecular meshwork.

  • Duration: The procedure is relatively quick.

  • Recovery: Patients might experience mild discomfort, with a short recovery period.


Benefits:

  • Precision: The excimer laser provides high precision in creating drainage channels.

  • Effectiveness: Can significantly reduce IOP.


Ideal Candidates:

  • Patients with primary open-angle glaucoma.

  • Those who have not responded adequately to other treatments.


4. Diode Laser Cycloablation


Overview:

Diode Laser Cycloablation targets the ciliary body to reduce the production of aqueous humor, thereby lowering IOP. It is typically used for advanced or refractory glaucoma.


Procedure:

  • Preparation: Local anesthesia is administered.

  • Laser Application: The diode laser is applied to the ciliary body to reduce aqueous humor production.

  • Duration: The procedure takes about 10-20 minutes.

  • Recovery: Patients may experience some pain and inflammation post-procedure.


Benefits:

  • Effectiveness: Particularly useful for cases where other treatments have failed.

  • Versatility: Can be used in various types of glaucoma, including advanced stages.


Ideal Candidates:

  • Patients with refractory glaucoma not responding to other treatments.

  • Individuals with advanced glaucoma requiring significant IOP reduction.


Conclusion

Laser treatments offer a range of options for managing different types and stages of glaucoma. From the minimally invasive SLT to the targeted approach of Diode Laser Cycloablation, these procedures provide effective, often long-lasting IOP reduction with varying levels of invasiveness and recovery times. By understanding these options, patients and their ophthalmologists can tailor treatment plans to best suit individual needs and improve outcomes in the fight against glaucoma.

If you or a loved one is dealing with glaucoma, schedule an appointment with one of our consultants to explore which laser treatment might be the most appropriate for your condition. The right laser procedure could significantly improve your quality of life and preserve your vision for years to come.

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Mr Ahmad Elsahn
ABOUT

Mr Ahmad Elsahn

Mr Ahmad Elsahn is a highly accomplished Consultant Ophthalmologist specialising in cataract surgery, minimally invasive glaucoma surgery and laser eye surgery, with over two decades of experience.

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