Fernández Vega Ophthalmological Institute - Secondary glaucoma - Instituto Oftalmológico Fernández Vega
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IRIDOTOMY

Iridotomy is a laser surgical treatment performed in the iris, the coloured area of the eye between the crystalline and the cornea.

Iridotomy is a laser surgical treatment performed in the iris, the coloured area of the eye between the crystalline and the cornea. It’s main objective is to improve intraocular drainage to avoid damage and loss of vision; it is therefore commonly used in the treatment of different types of glaucoma.

The procedure consists of performing a small hole, of approximately the size of a pinhead, through the external edge of the iris. This enables the creation of new drainage channels so that the aqueous humour flows from the posterior to the anterior chamber of the eye.

This procedure is fast and only requires a few drops of local anaesthesia to prevent the patient from suffering discomfort. However, during the intervention, the patient might feel a mild stinging sensation and see flashes of light. The procedure is very safe and effective, and has almost completely replaced traditional iridectomy, which required performing an opening of the eye and the partial manual removal of the iris.

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WHEN IS IT USED?

Iridotomy is one of the most efficient treatments for acute angle-closure glaucoma, which occurs when the drainage of the aqueous humour suddenly closes completely before the narrowing of the angle formed by the iris and the cornea. The fluid starts to accumulate within the eye, increasing intraocular pressure and even causing damage to the optic nerve, main cause for glaucoma-related vision loss. This is a rare case, but has to be considered a medical emergency and treated immediately.

Sometimes, laser iridotomy can also be used to re-establish a normal configuration of the iris; it is thus recommended to patients with pigmentary dispersion syndrome – when the iris bends backwards rubbing against the crystalline and releasing too much pigment.

RECOVERY AND RESULTS

While there may be some discomfort in the first few hours, recovery following iridotomy is immediate. Nevertheless, even if it is not advisable to drive within the first 24 hours, the procedure does not prevent the patient from leading a normal life. There are some exceptional incidences of vision loss following the procedure that may require further intervention.

The procedure has an effectiveness of approximately 100% in the prevention of acute glaucoma and in the stoppage of attacks. Results are perceived between 24 and 72 hours following the intervention. However, it is necessary to mention that there is currently no treatment to recover the loss of vision and that in some cases of glaucoma, additional measures may be needed to appropriately manage the disease.