YAG Laser peripheral Iridotomy

YAG Laser peripheral Iridotomy

This is a type of laser treatment to make a small hole (opening) in the peripheral iris (coloured part of the eye). This hole is called an “Iridotomy”. The aim of the hole is to assist fluid to flow from the front part of the iris to the other side and then out of the eye through drainage channels called the trabecular meshwork.

This laser treatment is recommended for patients who may have a narrow anterior chamber angle. The narrow angle can get blocked in certain situations, and this may compromise the drainage of the fluid inside the eye. This will lead to a sudden rise in eye pressure causing a condition called “Acute Glaucoma”. High eye pressure can damage the nerve of the eye and may lead to vision loss.

This laser opening will dramatically decrease this risk as it will allow fluid to flow freely inside the eye.

How to know if I have narrow angles?

This is usually picked up on routine examination at the optician or by an eye specialist. The optician may refer you for an eye specialist opinion if he feels the angle of the front part of the eye is narrow or the eye is at risk of angle closure. You may have no symptoms at all. However, some patients may report occasional headaches or episodes of blurred vision that can occur during watching TV in a dark room or reading or after emotional stress.

How is laser iridotomy performed?

The treatment is performed at the eye outpatient clinic. The doctor will put some drops to make your pupils small. Then you will be taken to the laser room. You will be asked to sit on a machine very similar to the eye examination machine.

The doctor will put some numbing drops and put a contact lens to stabilise the eye and perform the laser. The treatment takes only a few minutes. During the laser treatment, you may hear some clicking noises and you may see some bright lights or flashes. The doctor may put some drops to lower the eye pressure before or after the laser treatment. The treatment is not painful and is effective in most cases.

What happens after laser treatment?

Following the laser treatment, you will be asked to wait for 30-40 minutes for the doctor to check the eye pressure and to confirm the hole made in the iris is large enough. You will be given some anti-inflammatory drops to use at home for 1-2 weeks after the laser procedure. The doctor will arrange to review you again in 2-4 weeks to check the eye pressure and to make sure the laser hole is working correctly.

What are the benefits?

The laser treatment is performed to prevent the sudden rise in eye pressure if you are at risk. Without having this treatment, you are at risk of developing sudden glaucoma and irreversible loss of vision. It is important to remember that it will not restore any sight; neither will it improve your sight. The laser treatment is to prevent a sudden rise in pressure within your eye.

What are risks of YAG Laser Iridotomy?

YAG laser capsulotomy is a very safe and effective treatment in most cases. However, like any procedure, there is a small risk of complications as:

  • Temporary inflammation inside the eye (all patients are advised to use a short course of anti-inflammatory drops after the laser treatment).
  • Temporary increase in eye pressure (often treated with drops).
  • Small bleeding in the front part of the eye after the laser (uncommon). In most cases, it clears in a week
  • A cataract (cloudiness of the lens) may develop quickly in the eye that received laser treatment (very rare).
  • Build-up of fluid in the back of the eye known as macular oedema (very rare).
  • Sometimes, the hole may scar or close after a while. This may require another laser treatment (rare).

If you feel your vision has deteriorated after the laser, or experience any new symptoms, you should contact the doctor for an eye examination.