Experts refer to laser iridotomy (narrow-angle glaucoma surgery) as a short and painless laser procedure on the eye. During this laser operation, the laser creates a small hole in the iris (iris) of the eye. This creates a direct connection between the posterior and anterior chambers of the eye. This reduces the intraocular pressure. This can be necessary and helpful for diseases such as angle-closure glaucoma.
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Increased intraocular pressure can lead to damage to the optic nerve if left untreated. The consequences are loss of vision and a deterioration in visual acuity. Without treatment, glaucoma leads to complete blindness in the affected eye.
Laser iridotomy creates a hole in the iris to directly connect the posterior and anterior chambers of the eye. This allows fluids, such as aqueous humor, to drain easily from the posterior to the anterior chamber of the eye. Doctors can thus avoid or limit complaints and long-term consequences such as narrow-angle glaucoma. The patient does not feel the laser iridotomy hole in the eye. It does not cause any discomfort.
This makes laser iridotomy a targeted preventive measure for patients with a flat anterior chamber, pronounced hyperopia and the associated increased intraocular pressure.
Doctors usually perform laser iridotomy on an outpatient basis and under local anesthesia. It is painless and has few risks and side effects.
Surgical opening of the eyeball is not required for laser iridotomy and is only rarely necessary.
Other areas of application for a laser iridotomy are
Both conditions lead to an attack of glaucoma if left untreated, as the pressure in the eye increases. A laser iridotomy can also be helpful for other eye conditions that cause increased internal pressure.
It is estimated that around 10 million people in Germany suffer from cataracts.
It is estimated that around 10 million people in Germany suffer from cataracts @ New Africa /AdobeStock
Laser iridotomy is usually a preventive measure for increased intraocular pressure or as treatment for glaucoma that has already been diagnosed.
Before a laser iridotomy, the treating ophthalmologist clarifies whether the procedure makes sense and whether treatment is likely to be successful. The patient's general condition also plays a role in the decision.
In the case of a laser iridotomy, the doctor provides the patient with detailed information before the procedure. The main focus is on the patient's behavior before the operation. The patient must stop taking certain medication before the laser iridotomy and refrain from wearing contact lenses for some time.
During the preventive examinations, the doctor will determine how many holes are required to reduce the intraocular pressure.
During a laser iridotomy, the doctor first anesthetizes the patient's eye with eye drops. In rare cases (or if the patient expressly requests it), the procedure can also be performed under general anesthesia.
In this case, the patient must first clarify with the health insurance company whether they will cover the costs of general anesthesia. The pupil needs to be constricted for the procedure. Doctors can also achieve this with special eye drops.
For safety reasons, a chin rest stabilizes the patient. A special contact lens (similar to a contact lens) is then placed on the eye. A YAG laser then shoots a tiny hole through the protective and conductive lens.
This creates a direct connection between the posterior and anterior chambers of the eye. The laser dissolves the affected tissue areas with pinpoint accuracy. The surrounding tissue is not damaged during the laser iridotomy.
The laser iridotomy itself only takes a few minutes. If the preparations are included, the procedure is completed after half an hour.
Complications, risks and aftercare at 
Before the actual procedure begins, the patient is given eye drops for local anesthesia @ VICTOR TORRES/Stocksy /AdobeStock
After the treatment, the patient should rest for around three hours due to the medication. Only then can they drive again.
If they are accompanied, they can leave the practice or clinic immediately after the procedure.
The anesthesia required to place the contact lens directly onto the cornea lasts around ten minutes. Under certain circumstances, the doctor can prolong the effect of the anesthetic.
As the patient feels nothing, you as the accompanying person must make sure that they do not touch their eyes. The lack of pain sensation can lead to serious injuries to the eye.
The following side effects are known:
Laser iridotomy does not usually require extensive aftercare, as it is relatively painless and low-risk.
The laser iridotomy may need to be repeated several times, as the holes can quickly close again.
Patients should take care of their eyes for a few weeks after the procedure and avoid direct sunlight and sport.
In the first few days, you should not overdo it with television or working on the computer. As with reading, you should definitely take breaks if you notice that your eyes are straining. If you experience excessive or prolonged discomfort or pain, you should consult your doctor immediately.
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