What specific risks are associated with laser iridotomy?

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Laser iridotomy is a procedure used to treat and prevent angle-closure glaucoma by creating a small hole in the iris to improve fluid drainage. While it is generally considered safe and effective, like any medical procedure, it comes with certain risks. If you are considering laser iridotomy at the best eye hospital in Kolkata, understanding these risks will help you make an informed decision.

Understanding Laser Iridotomy

Laser iridotomy is a minimally invasive treatment performed to relieve intraocular pressure caused by a blocked drainage angle in the eye. The procedure uses a highly focused laser to create a tiny opening in the iris, allowing the aqueous humor (fluid inside the eye) to flow freely, reducing the risk of optic nerve damage and vision loss.

While the procedure is generally effective, there are risks associated with laser iridotomy that patients should be aware of before undergoing treatment.

Risks Associated with Laser Iridotomy

1. Increased Intraocular Pressure (IOP) Spike

Some patients may experience a temporary spike in intraocular pressure immediately after the procedure. This occurs due to inflammation or a sudden change in fluid dynamics within the eye. In most cases, this can be managed with medicated eye drops or oral medications.

2. Light Sensitivity and Glare

One of the most commonly reported risks associated with laser iridotomy is increased light sensitivity and glare. Patients may notice halos around lights, particularly at night. This happens because the newly created hole in the iris can allow extra light to enter the eye, leading to visual disturbances.

3. Corneal or Lens Damage

Although rare, accidental damage to the cornea or lens can occur if the laser energy is not precisely controlled. This may lead to vision disturbances, requiring further medical intervention.

4. Inflammation and Eye Redness

Inflammation, also known as iritis, is a common short-term side effect of laser iridotomy. Patients may experience eye redness, discomfort, or mild pain for a few days following the procedure. Anti-inflammatory eye drops are typically prescribed to manage these symptoms.

5. Bleeding from the Iris

Since the laser creates an opening in the iris, mild bleeding may occur at the treatment site. This is usually self-limiting and resolves on its own, but in rare cases, significant bleeding may lead to complications requiring medical attention.

6. Unequal Pupil Size (Anisocoria)

Some patients may experience a slight difference in pupil size after undergoing laser iridotomy. This is usually mild and does not significantly impact vision, but in some cases, it can be a cosmetic concern.

7. Failure to Control Glaucoma Progression

While laser iridotomy is an effective treatment for many patients, it may not always completely prevent the progression of angle-closure glaucoma. In such cases, additional treatments, including medications or surgery, may be necessary.

Minimizing Risks and Choosing the Best Eye Hospital in Kolkata

To reduce the risks associated with laser iridotomy, it is essential to undergo the procedure at a reputable and well-equipped facility. At Pushpanjali Eye Care, recognized as the best eye hospital in Kolkata, we ensure that every patient receives personalized care, advanced diagnostic evaluations, and treatment with state-of-the-art technology.

What are the long-term effects of laser iridotomy?

The main risks associated with laser iridotomy include both short-term and long-term complications.

Short-Term Risks:

• Transient Increase in IOP: The most common issue is a temporary elevation of intraocular pressure, usually within the first 4 hours after treatment. An increase of at least 8 mmHg from the baseline has been reported in 6% to 10% of patients, and an IOP greater than 21 mmHg in 2% to 72%. This is thought to be caused by obstruction of the trabecular meshwork.
• Anterior Chamber Bleeding (Hyphema): Bleeding from the iridotomy site is another common complication. It is usually minor and can be stopped by applying light pressure to the eye.
• Mild Discomfort, Light Sensitivity, and Blurred Vision: Temporary blurred vision is common but usually clears within a few hours. Some patients may feel slight discomfort or eye pain after the procedure. Some may experience sensitivity to light for a short time.
• Inflammation: Mild redness or inflammation may occur, but eye drops can help.
• Other risks: Headache or brow pain, eye redness, swelling or pain, foggy vision or seeing streaks of light.

Long-Term Risks:

• Cataract Progression: There is an increased risk of traumatic cataract development in the years following laser peripheral iridotomy (LPI).
• Iridotomy Closure: In some cases, the iridotomy can close over time due to the accumulation of debris and pigment granules. Repeat LPI can be performed if necessary. The hole in your iris will close in less than one-third of cases.
• Aqueous Misdirection Syndrome: In rare cases, aqueous misdirection can complicate the management of primary angle closure.
• Vision Problems: Some patients may experience visual dysphotopsias (glares, halos, lines, spots).
• Other complications: Rare complications include sterile hypopyon, macular hole formation, cystoid macular edema, and retinal hemorrhages.

Also Read: Laser Iridotomy for Glaucoma: FAQs, Benefits, and Recovery

Are there any lifestyle changes recommended post-laser iridotomy?

Yes, there are several lifestyle changes typically recommended after undergoing a laser iridotomy. These adjustments aim to support healing, stabilize eye pressure, and minimize potential complications.

Post-Procedure Guidelines:

• Activity Level: For the first few days, avoid strenuous activities and heavy lifting to prevent complications. Most surgeons recommend taking it easy during the first one to two weeks. Normal activities can usually be resumed within a day or two after the procedure.
• Eye Protection: Wear sunglasses for at least two weeks after the procedure to protect your eyes from the sun. Suitable eye protection should be worn when playing contact or ball sports, or during activities where something could poke your eye, such as gardening.
• Eye Cosmetics: Avoid eye makeup until the eye heals, and when you do restart, use new makeup and never share it.
• Contact Lenses: Contact lenses should not be used due to the risk of infection.
• Swimming: When swimming, wear loose-fitting goggles that do not press on the eye and ideally have no separation between the left and right eye compartments. Some surgeons may recommend only swimming in chlorinated pools and avoiding lakes or rivers to reduce infection risk.
• Follow-up: Attend follow-up appointments to monitor eye pressure and healing.
• Medications: Use prescribed eye drops to decrease inflammation and prevent infections.
• Avoid Rubbing Eyes: Please avoid rubbing your eyes for at least 2 days.
• Avoid Prolonged Eye Use: Avoid driving and using your eyes for a long time.

Post-Treatment Care and Precautions

Patients who undergo laser iridotomy should follow these guidelines to minimize risks:

• Use prescribed anti-inflammatory and pressure-lowering eye drops as directed.
• Avoid rubbing the eyes or engaging in strenuous activities for a few days.
• Wear UV-protected sunglasses to reduce glare and light sensitivity.
• Attend all follow-up visits to monitor intraocular pressure and healing progress.

FAQ

1. Is laser iridotomy a safe procedure?

Yes, laser iridotomy is generally safe, but it may have temporary side effects like light sensitivity, glare, or mild inflammation.

2. Can laser iridotomy cause vision problems?

Some patients may experience glare, halos, or light sensitivity, but these symptoms usually improve over time.

3. Does laser iridotomy increase eye pressure?

A temporary spike in intraocular pressure (IOP) can occur but is usually managed with medication.

4. Is bleeding a common side effect of laser iridotomy?

Mild bleeding from the iris may occur but typically resolves on its own without complications.

5. What should I do to reduce risks after laser iridotomy?

Follow post-procedure care, use prescribed eye drops, avoid rubbing your eyes, and attend follow-up checkups.

Conclusion

While laser iridotomy is a safe and effective procedure for treating angle-closure glaucoma, patients should be aware of the potential risks associated with laser iridotomy. Choosing the best eye hospital in Kolkata, such as Pushpanjali Eye Care, ensures that you receive expert care, advanced treatment options, and thorough post-procedure monitoring. If you are experiencing symptoms of angle-closure glaucoma or have been advised to undergo laser iridotomy, consult with our experienced ophthalmologists today for a comprehensive evaluation and treatment plan.