The laser trabeculoplasty procedure is minimally invasive and helps in treating progressing eye diseases, which lead to increased intraocular pressure (IOT). The technique of laser trabeculoplasty is an extra measure taken by optometrists to reduce intraocular pressure among patients suffering from open-angle glaucoma. This technique is also employed on patients with closed-angle glaucoma, provided they have a patent iridotomy. The laser for glaucoma procedure is proven to be safer than other alternatives.
Overview of Laser Trabeculoplasty
During laser trabeculoplasty surgery, a focused laser beam is applied to the trabecular meshwork. The meshwork is a drainage structure in the eye responsible for regulating the outflow of aqueous humour. The laser beam stimulates cellular changes within the trabecular meshwork. This improves its function and enhances the flow of fluid out of the eye.
Types of Laser Trabeculoplasty
Primarily, there are two types of trabeculoplasty laser surgery used in different patient conditions.
- Argon Laser Trabeculoplasty (ALT)
- Selective Laser Trabeculoplasty (SLT)
Argon Laser Trabeculoplasty
This is the most frequently used trabeculoplasty surgery suitable for patients with open-angle glaucoma. The aim of this surgery is to drain out fluids from the patient’s eye, ultimately decreasing intraocular pressure
What Happens During ALT?
While performing ALT, your surgeon will use a specialised lens to focus a high-energy beam of light onto the trabecular meshwork within your eye. The light will be reflected onto the meshwork, and you may perceive flashes of bright red or green light. This treatment usually involves 50–100 laser applications, administered evenly and at a controlled pace over a duration of 10 to 15 minutes. In most cases, the procedure can be completed within two sessions.
ALT does not require a surgical set-up. Once you are checked, your doctor will administer numbing drops to ensure you have no sensation in your eye under treatment. No injections are involved in the process. Moreover, an eyelid holder will be gently placed between your eyelids to prevent blinking and ensure the procedure is carried out smoothly.
The laser beam will cause targeted areas of your eye’s drainage system to contract. This leads to the opening and stretching of adjacent areas. The process facilitates faster drainage of fluid, helping to reduce intraocular pressure in the eye. You won’t experience any pain while going through the procedure.
Selective Laser Trabeculoplasty
SLT utilises low-energy, short-pulsed laser technology to target specific cells in the trabecular meshwork, the drainage system of the eye.
Unlike traditional laser trabeculoplasty techniques, such as argon laser trabeculoplasty (ALT), SLT selectively treats only specific pigmented cells, sparing surrounding tissue from thermal damage. This selective approach allows for repeat treatments if necessary without any harm.
What Happens During SLT?
During an SLT procedure, the laser is minutely focused on the trabecular meshwork, stimulating a biological response. This process improves the outflow of fluid from the eye, thus reducing IOP. The laser energy triggers biochemical changes, facilitating the removal of debris and increasing the permeability of the trabecular meshwork, allowing better drainage of aqueous humour.
Risks Associated with Laser Trabeculoplasty
The case studies of most patients show that glaucoma trabeculoplasty is a safe and reliable procedure for treating different kinds of glaucoma. It can be fruitful at any stage of glaucoma. However, there are a few risks one should be aware of before undergoing laser trabeculoplasty.
- Elevation of Intraocular Pressure: Even though the technique is specifically designed for reducing IP, patients have a spike in the IP in certain circumstances. However, this spike is, most of the time, short lived.
- Drainage System Scarring of the Eye: Especially in the case of ALT, there is a chase of scarring in your eye’s drainage system known as peripheral anterior synechiae (PAS). This problem does not cause any further damage to the eye. However, the effect of ALT is diminished in some cases.
