66761 Iridotomy/iridectomy by laser surgery (eg, for glaucoma) (per session)

Name of the Procedure:

Iridotomy/Iridectomy by Laser Surgery (e.g., for Glaucoma)

Summary

Iridotomy and iridectomy are laser surgeries performed to create a small hole in the iris (the colored part of the eye). This helps fluid drain from the eye, reducing intraocular pressure and preventing damage caused by glaucoma.

Purpose

This procedure addresses glaucoma, a condition characterized by increased intraocular pressure (IOP) that can damage the optic nerve and lead to vision loss. The primary goal is to lower IOP, thereby preserving eye health and preventing the progression of glaucoma.

Indications

• Acute angle-closure glaucoma (an emergency condition)
• Chronic angle-closure glaucoma
• Patients at high risk of developing angle-closure glaucoma
• Narrow or closed anterior chamber angles observed during an eye exam

Preparation

• No fasting is required.
• Patients may be instructed to stop certain medications before the procedure.
• An eye examination and measurement of IOP are conducted.
• Topical anesthetic drops are applied to the eye.

Procedure Description

1. The patient is seated at a specialized laser machine.
2. Anesthetic eye drops are administered to numb the eye.
3. A contact lens is placed on the eye to help focus the laser.
4. The surgeon uses the laser to create a small hole in the peripheral part of the iris.
5. The laser creates a passage for the aqueous humor to flow, reducing IOP.

Tools and Equipment:

• Laser machine (usually Argon or YAG laser)
• Contact lens for stabilizing the eye

Anesthesia:

• Topical anesthetic drops (no general anesthesia or sedation is typically required)

Duration

The procedure typically takes 10-20 minutes per eye.

Setting

This procedure is performed in an outpatient clinic or an ophthalmologist's office equipped with laser surgery technology.

Personnel

• Ophthalmologist (eye surgeon)
• Ophthalmic technician or nurse

Risks and Complications

Common Risks:

• Temporary blurring of vision
• Mild eye pain or discomfort
• Inflammation

Rare Complications:

• Bleeding in the eye
• Increased intraocular pressure
• Damage to the cornea or lens

Benefits

• Reduces intraocular pressure
• Prevents acute angle-closure glaucoma attacks
• Protects optic nerve function and preserves vision
• Benefits are realized almost immediately after the procedure

Recovery

• Avoid strenuous activities for a few days post-procedure.
• Use prescribed anti-inflammatory and pressure-lowering eye drops.
• Follow-up appointment with the ophthalmologist to monitor IOP and healing.
• Most patients resume normal activities within 1-2 days.

Alternatives

• Medications to lower IOP (e.g., eye drops)
• Surgical trabeculectomy or drainage implants (more invasive options)
• Pros and Cons: Medications may be less effective for some patients, while more invasive surgery carries higher risks but may be necessary for severe cases.

Patient Experience

• The patient might feel slight pressure or discomfort during the laser application.
• Mild aching or blurry vision may occur for a few hours post-procedure.
• Pain is typically minimal and manageable with over-the-counter painkillers if needed.