LASER PERIPHERAL IRIDOTOMY (PI)

In laser iridotomy the laser is used to create a channel through the iris (the coloured part of the eye). The purpose of the channel is to prevent or treat the sudden onset form of glaucoma, known as angle-closure glaucoma, which can occur in certain structurally pre-disposed eyes. It provides long-term protection against this type of glaucoma attack by creating a bypass for the fluid within the eye. If the attack has already occurred, it is an effective emergency treatment that saves the patient from more invasive surgery.

The iridotomy is virtually painless, so it does not require any anaesthetic other than eye drops. A special contact lens is placed on the eye to hold the lids open and focus the beam. Occasionally there is a little bleeding inside the eye which usually clears quickly.

The treatments do not involve the visual part of the eye, so apart from initial blurring for a few hours, vision usually quickly returns to normal. Due to the temporary blurring arrange for transport home and do not drive immediately afterwards.

MEDICATIONS BEFORE, DURING AND AFTER LASER TREATMENT
It is important to CONTINUE YOUR USUAL GLAUCOMA MEDICATIONS unless specifically told otherwise.

Risks and side effects

The most important serious side effect of PI is a sudden short-lived pressure rise an hour or two after PI. Very occasionally a prolonged period of inflammation occurs, and rarely a significant prolonged eye pressure rise. To lessen the risk of this happening we use eye drops (Alphagan, Timolol and/or Trusopt) both before and after laser treatment. If you are allergic to sulphur drugs you must tell us because you should not receive Trusopt drops. More serious but extremely rare risks include severe bleeding, cataract formation, or even retinal complications (none of which have been seen by the author in 20 years of ophthalmology!).

After PI:
Your doctor will advise you if you need to use Flarex. If you do, use one FLAREX drop every THREE hours for that day and the next day.

If you have any pain then take two Panadol on one occasion only. If that is inadequate then you must contact the doctor.

The eye may be red for 1-2 days. If the vision does not mostly recover within a few hours OR if the vision recovers and then goes blurry, you must contact the doctor immediately.