Cyclodiode Laser Treatment for GLAUCOMA
This is a type of laser used in patients with glaucoma where other types of treatment have failed or would be of little use or to avoid or delay the need for more invasive surgery.
If you have healthy eyes, the fluid in your eye (aqueous humour) flows through your pupil into the front of your eye. It then drains away through drainage channels inside the eye called the trabecular meshwork. These drainage channels are situated in the angle of the eye, which is where cornea (clear front layer of the eye) and iris (coloured part of the eye) meet.
However, in some eyes these drainage channels do not work properly, so your eye pressure increases. This increase in pressure may injure your optic nerve (the nerve that carries information from your eye to your brain) and impair your vision. This is called glaucoma.
In this trabeculoplasty procedure, a laser beam is applied to the drainage channels to unclog them. This means the aqueous humour flows through the channels better, reducing the pressure in your eye.
What happens on the day of the treatment?
It is important to use your normal eye drops and other medications on the day of your treatment unless your doctor has told you not to.
The procedure takes place in the operating theatre and may be done whilst you are asleep under general anaesthetic or more commonly under local anaesthetic (where the eye is numbed). The local anaesthetic involves drops that numb the front surface of your eye and an injection in the skin around your eye, which will make the area around your eye go numb. This may last for a few hours and can affect your vision at the time. The laser is then applied through the sclera (the white of your eye) using a pen-like instrument.
At the end of the procedure, an injection of steroid is given to help reduce inflammation that may occur following the laser treatment. An eye pad will be applied over the eye. You will be given drops to take at home. The procedure normally lasts around 20 minutes.
You will probably need to continue your glaucoma eye drops or tablets – you will be advised of this before you leave. We will arrange an appointment to come back to the clinic usually one to two weeks later.
Remember - It is important that you do not drive, and you may wish to arrange for someone to take you home.
Why should I have cyclodiode laser treatment?
It is important to remember that this procedure is performed to save the sight you still have. It will not restore any sight you may have already lost; neither will it improve your sight.
Cyclodiode laser treatment is generally successful and well tolerated. In some patients, the treatment has the additional benefit of reducing pain caused by high pressure.
What are the risks?
Your eye may be red and sore when the anaesthetic wears off. If this happens, you should take normal painkillers. Your sight may be blurred for a few days or even a few weeks, but it should settle down to how it was before the laser treatment was performed.
In 30% of cases, patients need repeat treatment with the laser to achieve low pressure in the eye.
It is rare to have any serious complications after this procedure. In some cases reduced vision may last for up to six weeks. The pressure may be too high or low following treatment. In very rare cases persistently very low pressure can cause permanent loss of vision and alter the cosmetic appearance of the eye.
Are there any alternatives?
This type of laser is used in patients with glaucoma where other types of treatment have failed or would be of little use. If you do not have the laser treatment, there is a risk that the sight, or the pain, in your eye will get worse because of the glaucoma.
How successful is it in lowering the eye pressure?
Over 80% of patients who have their eyes treated by laser in this way have a successful lowering of pressure. The effects of the laser can wear off in time but may last for months or years. The treatment can be repeated if necessary.