Glaucoma is characterized by damage to the optic nerve, often resulting from elevated intraocular pressure (IOP). This pressure increases when the eye’s natural drainage system is compromised, preventing fluid from flowing out correctly. To manage this pressure and prevent further vision loss, ophthalmologists often recommend laser surgery. Laser procedures are minimally invasive and work by improving fluid outflow or creating a new drainage pathway, effectively reducing pressure inside the eye.
Defining the Procedure Types and Duration
The actual time spent under the laser is brief, though it varies depending on the specific procedure performed. The three most common laser treatments for glaucoma are Selective Laser Trabeculoplasty (SLT), Argon Laser Trabeculoplasty (ALT), and Laser Peripheral Iridotomy (LPI). Each method targets a different part of the eye’s drainage anatomy and has a distinct duration.
Selective Laser Trabeculoplasty (SLT) is a popular option for open-angle glaucoma. It utilizes a low-energy laser to treat the trabecular meshwork, the drainage tissue, without causing thermal damage. The procedure works by stimulating a biological response that improves fluid outflow. The laser application typically takes only three to five minutes per eye, though some treatments may extend up to 15 minutes.
Argon Laser Trabeculoplasty (ALT) is also used for open-angle glaucoma. It uses a continuous-wave laser to create microscopic burns on the drainage meshwork, stretching the tissue and opening the channels. The laser application for ALT is quick, often completed in ten minutes or less per eye. Laser Peripheral Iridotomy (LPI) treats or prevents angle-closure glaucoma by creating a small hole in the peripheral iris, allowing fluid to bypass a blockage. LPI takes the shortest amount of time, often lasting just one to five minutes per eye.
What Happens During the Surgery
The total time spent in the clinic is longer than the few minutes of laser application, accounting for preparation and post-procedure steps. The process begins with topical anesthetic drops to numb the eye’s surface. The doctor may also apply pressure-lowering drops, such as apraclonidine, before the laser is used. These drops help mitigate any temporary rise in eye pressure that can occur immediately following the procedure.
The patient is seated at equipment similar to a slit lamp microscope, resting their chin and forehead firmly against supports. A specialized contact lens is then placed directly on the eye’s surface. This lens helps stabilize the eye and precisely focus the laser beam onto the target tissue. During the brief laser application, the patient may see bright flashes of light or hear a rapid clicking sound as the laser fires.
The doctor carefully guides the laser using the contact lens and the slit lamp’s view, applying a specific number of laser spots to the drainage angle or iris. Since no incisions or stitches are involved, the procedure is performed on an outpatient basis in the clinic’s laser room. Once the laser spots are delivered, the contact lens is removed, and the treatment phase is complete.
Immediate Post-Procedure Experience and Recovery Timeline
The time immediately following the laser application is dedicated to ensuring the eye’s pressure is stable before the patient leaves. After the laser is completed, a clear gel or drops are applied to the eye. The patient is asked to wait in the clinic for 30 to 60 minutes while the intraocular pressure is checked again. This monitoring is necessary because a temporary pressure spike is a possible side effect that must be managed immediately.
Due to the numbing drops and bright light exposure, vision may be temporarily blurry or darkened for a few minutes to a few hours following the procedure. Patients are advised to arrange for someone to drive them home, as driving is not permitted immediately after the treatment. The overall appointment time, including preparation, the procedure, and post-laser monitoring, typically ranges from one to two hours.
For short-term recovery, the doctor will often prescribe anti-inflammatory eye drops to reduce irritation or mild inflammation for several days. Most individuals can resume normal daily activities, such as reading and light work, the day after the procedure. Strenuous activities, heavy lifting, and swimming are avoided for a few days to a week to ensure proper initial healing.