Laser Glaucoma Surgery

Glaucoma is one of the leading causes of blindness in the United States, according to the National Eye Institute.

There are no warning signs in the early stages of the disease, so it’s vital to have your eyes checked regularly.

At Focus Eye Care & Surgery, our board-certified eye surgeon, Dr. Neelofar Ghaznawi, specializes in cornea diseases. She will conduct a thorough evaluation and develop a treatment plan with you to preserve your vision or prevent further vision loss.

What Is Glaucoma?

Glaucoma is an eye disease that damages the optic nerve.

The optic nerve sends electrical signals from the retina, the light-sensitive layer at the back of the eyes, to the brain where an image is formed.

How Is the Optic Nerve Damaged?

In glaucoma, the optic nerve is damaged because of high intraocular pressure (IOP). This means that the pressure within the eyes is too much that it presses on parts of the eyes that either directly or indirectly damage the optic nerve.

When the optic nerve is damaged, either gradual or acute vision loss occurs. At present, vision loss from glaucoma is irreversible, unless the disease is caught early and preventive surgery is performed. Get your eyes checked at Focus Eye Care & Surgery to ensure you are not at risk, or to take action early if you are.

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What Causes Intraocular Pressure?

The inefficient or blocked drainage of aqueous humor causes IOP. Aqueous humor is produced just behind the iris (the colored part of the eyes), flows out of the pupil (the opening of the eyes), and drains through a porous channel in the cornea called trabecular meshwork.

Aqueous humor is vital to keeping the eye nourished and the eyeball in globular shape. (Conversely, when the IOP is too low, the eyeball would collapse like a deflated ball, resulting also in visual impairment, if not total vision loss.)

What to expect?

Our laser cataract surgery in New York is performed as an outpatient procedure. Barring complications, you are able to go home the same day. After the surgery, you will notice significant improvement in your vision right away. It is normal for your vision to blur a few days after the operation.
As your eye heals, avoid any strenuous activities like heavy lifting or exercise a few weeks after the procedure.

How long does it take?

Using the latest surgical techniques and state-of-the start technology, our New York cataract surgeon is able to perform the procedure in 30 minutes or less.

You will spend around 2-3 hours in an office setting to prepare you for the procedure, and to observe you after the surgery to ensure your safety.

What Are the Types of Glaucoma?

The following are the most common types of glaucoma in the United States:

Open-angle glaucoma

The most common type of glaucoma, this disease happens when the aqueous humor does not drain out of the trabecular meshwork as well as it should. The result is a gradual buildup of fluid that eventually presses on the optic nerve.

Because open-angle glaucoma often has no symptoms early on until peripheral vision is lost (like looking through a tunnel), it’s called the ‘silent thief of sight.’

Narrow-angle glaucoma

This type of glaucoma happens when the iris is pressed too close to the drainage angle such that the trabecular meshwork is not exposed. This clogging causes a backup of aqueous humor, and consequently a quick rise in IOP.

Symptoms include headache, severe forehead or eye pain, sudden blurry vision, nausea, and vomiting. This acute attack needs emergency medical attention to prevent blindness.

Normal pressure glaucoma

This disease happens even without an increase in intraocular pressure. People with normal IOP may sustain damage to their optic nerve because of the optic nerve’s unusual sensitivity to any form of pressure.

Treatment Options for Laser Glaucoma Surgery

At Focus Eye Care & Surgery, our New York eye surgeon uses the latest laser technology and in-office FDA-approved laser treatments to manage intraocular pressure.

Selective Laser Trabeculoplasty (SLT)

SLT is the first line of treatment for open-angle glaucoma. It’s a simple procedure that involves focusing a laser through a contact lens to stimulate a biochemical change that exposes the trabecular meshwork. This reduces IOP and normalizes the drainage of aqueous humor.

SLT has long been proven as safe, simple, and with little discomfort. It also does not permanently damage the trabecular meshwork.

Laser Peripheral Iridotomy (LPI)

LPI is the first line of treatment and prevention for narrow-angle glaucoma patients and suspects (people who may or may not develop acute attacks). A laser is beamed in the outer edge of the iris to create a pinprick hole. The aim is to normalize the pressure between the cornea and iris so the trabecular meshwork is exposed. The result is better fluid drainage and lowered IOP.

Pretreatment often takes half an hour, with the actual laser surgery taking about 10 minutes. Minor pain and blurry vision may be experienced afterward.

Normal pressure glaucoma is treated similar to open-angle glaucoma. The goal is to lower the IOP to a point where the otherwise normal pressure does not cause damage to the optic nerve.

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5161772/

https://pubmed.ncbi.nlm.nih.gov/30878226/

https://pubmed.ncbi.nlm.nih.gov/29482864/

https://www.aao.org/editors-choice/dysphotopsia-far-more-common-after-superior-laser-

https://www.brightfocus.org/glaucoma/article/laser-procedures-glaucoma

https://www.brightfocus.org/glaucoma/article/peripheral-iridotomy-laser-procedure-narrow-angles

https://eyewiki.aao.org/Laser_Trabeculoplasty:_ALT_vs_SLT

http://medcell.med.yale.edu/histology/sensory_systems_lab/flow_aqueous_humor.php

https://www.ncbi.nlm.nih.gov/books/NBK553209/

https://www.aao.org/eye-health/ask-ophthalmologist-q/low-eye-pressure

https://faculty.washington.edu/chudler/glaucoma.html

https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/glaucoma/treatment

https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/glaucoma/glaucoma-surgery

FAQ

How can glaucoma be treated?

Glaucoma can cause irreversible damage to vision; therefore, treatment of glaucoma should be done as early as possible to prevent vision loss. Glaucoma is treated by lowering the pressure within the eyes by using various medications or via surgery. Medications can be in the form of either eye drops or orally administered drugs. Both oral drugs and eye drops work by either increasing the outflow of fluid from the eye or by decreasing the production of aqueous humor, which is the fluid within the eye. If medications do not decrease the pressure sufficiently, surgery can improve drainage of fluid from the eye by opening or widening blocked outflow tracts.

How long is the recovery time for laser glaucoma surgery?

Complete recovery and healing after laser glaucoma surgery may require at least 3 to 4 weeks. But any blurriness in your vision as a result of the surgery will improve after 24 to 48 hours, and you can expect to resume work within a week.

Are the results of laser glaucoma surgery permanent?

Laser glaucoma surgery is a method to widen the outflow tract for the fluid in your eyes to lower eye pressure and slow glaucoma progression. The results achieved from laser glaucoma surgery can provide benefits for a few years, but you may need further follow-ups and treatments to manage glaucoma as it is not a curable condition.

Is laser glaucoma surgery a major or minor surgery?

Laser glaucoma surgery is a minor, minimally invasive surgery done on an outpatient basis. You will be back home on the same day as the actual procedure takes only 10 minutes.

What is the success rate of glaucoma surgery?

The success rate of glaucoma surgery as per studies is nearly 80%. However, the long-term success rate can vary, and some patients may require further treatments to manage glaucoma. The success rate also depends upon the stage of glaucoma. Early-stage glaucoma has higher success rates than advanced glaucoma with significant vision loss.

Will I be able to drive after glaucoma surgery?

Following glaucoma surgery, your vision may be blurred for a few hours to one day due to inflammation. Therefore, you cannot drive yourself home after the surgery and will need to ask a friend or family member to assist you. However, after glaucoma surgery, if the glaucoma was treated early on and has not affected your vision, you can drive once you receive clearance from your ophthalmologist.

Is laser glaucoma surgery covered by Medicare?

Yes, glaucoma surgery is covered by Medicare. Medicare generally covers all laser eye procedures that are identified as medically necessary. Coverage for glaucoma surgery falls under Medicare Part B.

Are you at risk of developing glaucoma?

Call us now and have your eyes checked by our New York-based glaucoma specialist. The earlier you catch glaucoma, the better your chances of preserving your vision and your quality of life.