Iridoplasty is a laser procedure designed to reshape the iris, the colored part of the eye, to improve fluid drainage. This treatment targets the peripheral iris, which is the outer edge of this structure. By carefully altering the iris, the procedure aims to create more space within the eye’s drainage angle. This increased space facilitates the outflow of aqueous humor, the fluid that nourishes the eye, helping to manage intraocular pressure. An argon laser applies controlled burns to the iris tissue.
Medical Conditions Requiring Iridoplasty
The eye’s drainage angle is a small drain located where the iris meets the cornea, the clear front surface of the eye. This angle is where aqueous humor exits the eye, maintaining healthy internal pressure. When this drainage pathway becomes too narrow or obstructed, it can lead to elevated eye pressure and potential vision problems.
One specific condition that often requires iridoplasty is Plateau Iris Syndrome (PIS). In PIS, the ciliary body, a structure behind the iris, is positioned unusually forward, or the iris itself inserts anteriorly on the ciliary body. This anatomical arrangement pushes the peripheral iris forward, blocking the drainage angle, even after a laser peripheral iridotomy.
Iridoplasty addresses this anatomical issue by contracting the peripheral iris tissue, pulling it away from the trabecular meshwork, the eye’s drainage filter. This action widens the anterior chamber angle, allowing for improved aqueous humor outflow. While laser iridotomy is often the initial approach for angle closure, iridoplasty is considered when the angle remains persistently narrow or closed due to plateau iris. It can also be used in acute angle-closure situations where corneal swelling prevents an iridotomy.
The Iridoplasty Procedure
Iridoplasty is typically a quick, outpatient procedure performed in an ophthalmologist’s office. Before treatment, the eye is prepared with anesthetic eye drops for comfort, along with miotic drops to constrict the pupil and stretch the iris, which helps to expose the peripheral iris for treatment. Additional drops, such as brimonidine or apraclonidine, may also be administered to help reduce the chance of a post-procedure increase in eye pressure.
The patient sits at a machine similar to one used for routine eye examinations, resting their chin on a support. A special contact lens is gently placed on the eye to stabilize it and focus the laser beam precisely. The ophthalmologist uses an argon laser to deliver small, controlled burns to the outer edge of the iris. These laser applications, 20 to 24 spots, cause the iris tissue to shrink and contract, pulling it backward and away from the drainage angle. The procedure takes about five to fifteen minutes per eye, with discomfort described as a mild stinging sensation.
Recovery and Follow-Up Care
After the iridoplasty procedure is complete, patients may experience temporary side effects. Blurred vision and increased light sensitivity are common immediately following treatment, but these symptoms resolve within a day or two. Mild eye irritation or a gritty sensation may also be present as the eye heals.
A standard post-procedure regimen involves prescribed anti-inflammatory eye drops, applied for four to five days to manage inflammation. In some cases, eye pressure-lowering drops may also be given to prevent a temporary spike in intraocular pressure. Patients are advised not to drive immediately after the procedure due to blurred vision. A follow-up appointment is scheduled within a week to assess eye pressure and confirm treatment effectiveness. Further follow-up visits may be needed to monitor long-term results and ensure continued eye health.