Glaucoma is a collection of eye disorders that progressively damage the optic nerve, which transmits visual information from the eye to the brain. This damage frequently results from high intraocular pressure (IOP) caused by a disturbance in the eye’s natural fluid balance. When the drainage system is blocked or works inefficiently, the clear fluid called aqueous humor builds up, raising the pressure. Glaucoma laser surgery lowers this pressure by improving the eye’s ability to drain the aqueous humor or by reducing fluid production, aiming to preserve existing vision and prevent further vision loss.
The Main Types of Glaucoma Laser Surgery
Laser procedures for glaucoma are categorized based on their target within the eye’s anatomy. The two primary categories are procedures that enhance fluid outflow through the drainage angle and those that create a new fluid pathway. These procedures are typically performed in an outpatient setting.
Selective Laser Trabeculoplasty (SLT) and Argon Laser Trabeculoplasty (ALT) are used primarily for open-angle glaucoma, where the drainage angle is open but the meshwork is clogged. SLT uses a low-energy laser to stimulate specific cells in the trabecular meshwork, increasing fluid outflow. ALT uses a continuous wave laser to create tiny burns, which also helps fluid drain more effectively, though it is less repeatable than SLT.
Laser Peripheral Iridotomy (LPI) is the procedure of choice for narrow-angle or angle-closure glaucoma, which occurs when the iris blocks the drainage angle. LPI uses a laser to create a small, peripheral opening in the iris, allowing the aqueous humor to bypass the blockage and relieve the pressure.
Actual Procedure Duration
The time spent actively applying the laser energy to the eye is surprisingly brief. For Selective Laser Trabeculoplasty (SLT) and Argon Laser Trabeculoplasty (ALT), the actual laser application typically takes less than 10 to 15 minutes per eye. The process involves numbing the eye and placing a specialized contact lens on the eye to direct the laser beam.
During the procedure, the patient sits at a machine similar to a standard eye examination device, where the doctor delivers a sequence of rapid, focused laser pulses. Selective Laser Trabeculoplasty often takes only about five to ten minutes to complete. Laser Peripheral Iridotomy (LPI) is also a very fast procedure, often completed in a similar timeframe. In many cases, only one eye is treated at a time.
Total Time Commitment
While the laser application itself is short, the total time a patient spends at the clinic or hospital is significantly longer due to necessary preparation and post-procedure checks. Patients should plan for a total time commitment of one to two hours for the entire outpatient visit, which includes administrative steps like check-in.
A large portion of the overall time is dedicated to preparing the eye for the treatment, which includes the application of anesthetic drops to numb the eye. Eye drops may also be administered to manage inflammation or to constrict the pupil before the procedure, depending on the type of laser treatment.
Following the laser treatment, patients are required to remain for a period of observation, which is critical for safety. A final check of the intraocular pressure is performed approximately 45 to 60 minutes after the procedure to ensure the pressure has not risen unexpectedly. This monitoring period, combined with the preparation time, accounts for the majority of the one to two-hour appointment duration.
Immediate Post-Procedure Experience
Immediately after the procedure, once the pressure check is complete and the contact lens is removed, patients receive instructions for the next few hours and days. It is common to experience temporary side effects such as mild redness, slight irritation, or a gritty sensation in the treated eye. Blurry vision is also an expected effect, often due to the numbing gel or drops used during the process.
Patients are typically prescribed anti-inflammatory eye drops to be used for a few days to manage any swelling or discomfort. Patients must arrange for a driver, as the temporary blurriness and dilation can make it unsafe to operate a vehicle. Patients are instructed to avoid strenuous activity, heavy lifting, and activities that could introduce contaminants to the eye for the remainder of the day. Most people are able to return to normal activities the following day.