SLT uses a lower- energy laser to selectively treat pigmented cells within the drain of the eye. This is a relatively new type of Laser treatment for Open angle type of glaucoma.Intially Argon Laser was being used to the same effect.However it is now given up and SLT is the more safe and refined version of the same. The advantages of SLT is that it is a painless short procedure. Following treatment there is a modest reduction in the intraocular pressure. This may help the treating physician to withdraw one or two antiglaucoma medications being used This is especially beneficial in the subset of patients where certain antiglaucoma medications are either contraindicated or not tolerated.It is also beneficial as the first line of therapy in early glaucoma where intraocular pressure elevation is not very high.Its also useful in Ocular Hypertensives.
This procedure has almost negligible side effects. However re-treatments might sometimes be required.
When glaucoma continues to progress despite the use of medication regimens and possibly laser treatments, a glaucoma filtration procedure (trabeculectomy) may be recommended. The goal of the glaucoma filtration procedure is to create a new passageway by which aqueous fluid from inside the eye can escape, thereby lowering the pressure.
Transscleral cyclophotocoagulation is a procedure for glaucoma that is performed on an outpatient basis. In this procedure, the ciliary body of the eye, which creates aqueous fluid, is treated with laser to decrease production of aqueous. This in turn reduces pressure inside the eye. The technology has been available for nearly 30 years, but has only recently become available to glaucoma patients. Nethradhama takes the privilege to perform the procedure for intractable glaucoma first time in Karnataka. Laser Deep Sclerectomy is a less invasive technique than filtering surgery that leaves the anterior chamber (front of the eye) intact and avoids creation of blebs. In deep sclerectomy, the surgeon removes a deep piece of the sclera (the white part of the eye), part of the trabecular meshwork, and the front of Schlemm's canal (the vessels that return fluid into the blood stream).
In cyclocryotherapy, an extremely cold instrument (probe) is repeatedly applied to the sclera, the white part of the eye. The probe destroys the ciliary body, the part of the eye that produces fluid. Cyclocryotherapy may be used to treat severe glaucoma that has not improved after other types of treatment or surgery have been tried.
If topical and/or oral therapy is not controlling the intraocular pressure (IOP), or if the patient is not taking their medicine according to schedule, laser surgery treatment may be an effective alternative or adjunct. The laser is usually used in one of two ways. In open-angle glaucoma, the laser is used to enlarge the drain (Diode laser trabeculoplasty) to help control eye pressure. In angle-closure glaucoma, the laser creates a hole in the iris (Yag Laser Iridotomy) to improve the out flow of aqueous fluid to the drain.
Yag laser iridotomy is performed almost exclusively for patients with narrow angle glaucoma, or acute angle closure glaucoma. Yag laser iridotomy involves making a tiny opening in the iris with a laser, which allows fluid to drain freely. The laser peripheral iridotomy procedure is usually completed as a brief outpatient procedure. Prior to the procedure, the pupil is often constricted with an eye drop medication known as pilocarpine. The procedure itself is completed with the patient seated at the laser, and requires no sedation. Usually, a lens is placed on the eye after topical anesthetic drops are applied to better control the laser beam. The entire procedure only takes a few minutes. The lens is then removed from the eye, and vision will quickly return to normal. After the procedure, your eye surgeon may recommend anti-inflammatory eye drop medications for the next few days. A post-op visit will be scheduled.