65855 Trabeculoplasty by laser surgery

Name of the Procedure:

Trabeculoplasty by laser surgery

• Common names: Laser Trabeculoplasty, Argon Laser Trabeculoplasty (ALT), Selective Laser Trabeculoplasty (SLT)

Summary

Laser trabeculoplasty is a minimally invasive surgical procedure used to treat open-angle glaucoma. It involves using a laser to improve the drainage of fluid from the eye, thereby reducing intraocular pressure (IOP).

Purpose

Medical Condition: Open-angle glaucoma Goals:

• Lower intraocular pressure (IOP)
• Prevent or slow down vision loss

Indications

• Patients diagnosed with open-angle glaucoma.
• Increased intraocular pressure not adequately controlled by medications.
• Failure or intolerance to glaucoma eye drops.
• Patients looking for a less invasive option before considering more extensive surgical procedures.

Preparation

• Patients may be advised to stop certain medications before the procedure.
• Pre-procedure eye examination.
• Intraocular pressure measurement.
• Possible administration of eye drops to prepare the eye.

Procedure Description

1. The patient is seated in a comfortable position.
2. Numbing eye drops are applied to the eye.
3. A special lens is placed on the eye.
4. The laser is directed at the drainage angle (trabecular meshwork) of the eye.
5. Laser pulses are delivered to create small burns or targeted energy spots to enhance fluid drainage.
6. The procedure is usually performed on one eye at a time.

Equipment:

• Laser device (Argon laser for ALT, frequency-doubled Nd:YAG laser for SLT)
• Gonio lens

Anesthesia:

• Topical anesthetic eye drops (no general anesthesia required)

Duration

The procedure typically takes about 10-20 minutes per eye.

Setting

Performed in an outpatient clinic or an eye care specialist's office.

Personnel

• Ophthalmologist (eye surgeon)
• Medical assistant or technician

Risks and Complications

Common Risks:

• Temporary increase in intraocular pressure
• Redness or eye irritation

Rare Complications:

• Inflammation
• Eye infection
• Vision changes
• Damage to the trabecular meshwork

Benefits

• Reduction in intraocular pressure
• Delay or prevention of further vision loss
• Minimized reliance on glaucoma medications

Recovery

• Patients can usually go home shortly after the procedure.
• Mild redness or discomfort in the eye, which can be managed with prescribed eye drops.
• Follow-up visits to monitor intraocular pressure.
• Avoid strenuous activities for a few days.

Alternatives

• Glaucoma medications (e.g., eye drops)
• Incisional surgery (e.g., trabeculectomy, glaucoma drainage implants)
• Laser peripheral iridotomy (for angle-closure glaucoma)

Pros and Cons:

• Medication adherence can be difficult for some patients.
• Incisional surgeries carry higher risks and longer recovery times compared to laser trabeculoplasty.

Patient Experience

• Usually no pain during the procedure due to numbing eye drops.
• Mild discomfort or foreign body sensation afterward.
• Post-procedure eye care includes using prescribed medications and attending follow-up appointments.