Some people may need eye surgery to control their glaucoma. Lasers are very useful for treating glaucoma because they avoid cutting and have a lower chance of complications (compared to glaucoma surgery).
There are three common laser procedures:
Laser trabeculoplasty or selective laser trabeculoplasty improves the outflow of aqueous fluid. A laser is used to make from 50 to 100 tiny burns in the trabecular meshwork. The procedure opens up the mesh-like outflow pathway to improve draining of fluids from the eye. Sometimes your doctor may perform this procedure over two visits. The benefit of the treatment may last for a few years, but it is not a cure. More than half the people who have this surgery need additional treatment within five years. Repeat laser trabeculoplasty may be used to treat patients who had a good first effect with laser treatment, but over time have lost some of the pressure-lowering response. Treatment beyond a second laser treatment is most often not effective.
A peripheral iridotomy is most often used to treat narrow angle or angle closure glaucoma. The laser beam creates a tiny hole in the colored part of the eye (the iris). This lets the pressure in front of the iris become the same as the pressure behind the iris. As a result, the iris moves away from the drainage angle and the aqueous fluid can resume draining normally.
People usually don't feel any pain with these procedures, although some report a slight stinging. Most patients take it easy the day of their treatment, but go back to their normal routine the following day.
Many people need to keep taking medicines even after laser surgery.
Laser surgery is usually successful, but there are some risks. These include a temporary, generally short-term increase in eye pressure, temporary inflammation of the eye, and possibly a slightly increased risk of developing cataracts.