Laser Peripheral Iridotomy

Laser peripheral iridotomy makes a tiny hole in the outer edge of the iris, the coloured part of the eye, with a YAG laser. The hole gives fluid a bypass route from behind the iris to the front, which flattens the iris and opens a narrow drainage angle.

It prevents or treats acute angle closure, a sudden and painful rise in eye pressure that can damage sight within hours. It does not improve vision, does not treat the common open angle form of glaucoma, and some eyes still need drops, further laser or lens surgery.

What Laser Peripheral Iridotomy involves

Narrow angles are diagnosed by gonioscopy, in which a mirrored contact lens is used to view the drainage angle, often supported by anterior segment OCT. About 30 to 60 minutes before the laser, pilocarpine drops are given to shrink the pupil and stretch the iris thin, and another drop to blunt any pressure spike. With anaesthetic drops in, a special contact lens is placed on the eye to focus the beam and keep the lids open. The doctor selects a site in the outer iris, usually under the upper lid or at the 3 or 9 o'clock position, preferably in a thin crypt, and fires a few short YAG pulses until a gush of pigment shows that the hole is through. In thick brown irises an argon or green laser may first thin the tissue. Pressure is rechecked after 30 to 60 minutes.

Who is a good candidate for Laser Peripheral Iridotomy?

Both eyes are usually treated, since the anatomy is almost always the same on both sides.

• An acute angle closure attack, once the cornea has cleared enough; and the fellow eye as prevention
• Primary angle closure with raised pressure or adhesions in the angle
• Narrow angle suspects at higher risk: strong family history, need for frequent pupil dilation, poor access to emergency eye care, or symptoms of intermittent closure
• Pigment dispersion with a backward-bowing iris, in selected cases

Es ist normalerweise nicht die richtige Wahl, wenn:

• Open angle glaucoma
• Angle closure caused by a bulky cataract, where lens extraction is often the better treatment
• Angles closed by new vessels or inflammation, which need different treatment
• A cloudy cornea that prevents a clear view
• Many low risk narrow angle suspects can simply be observed, according to a large trial

Technikoptionen

• Nd:YAG laser iridotomy: The standard method; a few pulses.
• Sequential argon then YAG: Thick dark irises, less bleeding.
• Lens extraction (early cataract surgery): Opens the angle more effectively in angle closure with raised pressure, especially over age 50.
• Laser iridoplasty: For plateau iris when the angle stays narrow despite a patent iridotomy.

Was passiert während Ihrer Behandlung

The laser itself takes 5 to 10 minutes per eye, sitting at a machine that resembles the usual slit lamp. You feel a brief pinch or a click inside the eye with each pulse. Vision is blurred for a few hours from the drops and the gel. Allow 2 hours for the whole visit because of the pressure check.

Vorbereitung auf Ihre Reise

One session per eye; both eyes can be done on the same day or a few days apart. Allow a pressure check at about 1 hour and a review with gonioscopy after 1 to 2 weeks, which can be done at home if you are travelling. A stay of 3 to 5 days covers laser to both eyes and a first review.

• Informieren Sie den Arzt über Medikamente, Allergien, Schwangerschaft oder Stillen und eine Vorgeschichte von Fieberbläschen, Keloidnarben oder Autoimmunerkrankungen
• Vermeiden Sie Alkohol, Aspirin und entzündungshemmende Schmerzmittel für ein paar Tage im Voraus, wenn Ihr eigener Arzt zustimmt, um Blutergüsse zu reduzieren
• Kommen Sie ohne Make-up auf dem Behandlungsbereich an und vermeiden Sie zwei Wochen vorher Sonnenliegen und starke Sonne

Genesung und Ergebnisse

Steroid drops are used for 5 to 7 days. Mild ache, redness, light sensitivity and blurred vision settle within 1 to 2 days, and you should not drive on the day. The angle is checked again with gonioscopy at the review. Long-term you still need yearly eye pressure and optic nerve checks, as angle closure disease can progress and cataract develops a little sooner.

• Back to everyday activity: Rest of the day
• When results show: Angle opens at once; checked at 1 to 2 weeks
• How long they last: Usually permanent

Sicherheit, Risiken und Revisionspolitik

It is a quick and safe laser, with mostly minor and temporary side effects.

• A temporary pressure spike in the first hours
• A small bleed from the iris that blurs vision for a day
• Inflammation inside the eye
• Glare, a ghost line or a crescent of light from the hole, in a few percent; less likely with careful placement
• Closure of the hole needing re-treatment
• Rarely, corneal or lens damage
• Slightly faster cataract progression

Jeder schriftliche Vorschlag wird durch Clinic-Y gibt an, was die Klinik abdeckt, wenn eine Korrektur erforderlich ist. Fragen Sie danach, bevor Sie buchen, nicht danach.

Cost of Laser Peripheral Iridotomy in Türkiye

Clinic-Y does not publish a single price for Laser Peripheral Iridotomy, because the honest figure depends on your case. What moves it:

• One or both eyes
• Pre-laser imaging such as anterior segment OCT and visual field tests
• Type of laser used
• Follow-up visits and drops

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