66762 Iridoplasty by photocoagulation (1 or more sessions) (eg, for improvement of vision, for widening of anterior chamber angle)

Name of the Procedure:

Iridoplasty by Photocoagulation (1 or more sessions) Common name: Laser Iridoplasty

Summary

Laser iridoplasty is a minimally invasive eye procedure that uses a laser to reshape the iris. This is done to improve vision and widen the anterior chamber angle of the eye, which can help in managing certain conditions like narrow-angle glaucoma.

Purpose

The primary goal is to widen the anterior chamber angle to prevent or treat angle-closure glaucoma. It can also improve vision in patients with certain iris abnormalities.

Indications

• Narrow-angle glaucoma or angle-closure glaucoma
• Shallow anterior chamber angle
• Iris abnormalities causing vision issues
• Patients unresponsive to medical therapy

Preparation

• Stop any blood-thinning medications as advised by the doctor.
• Undergo a thorough eye examination and possibly imaging tests like gonioscopy.
• Use prescribed eye drops before the procedure to prepare the eye.

Procedure Description

1. The patient is seated in front of a specialized laser machine.
2. Eye drops are administered to numb the eye and constrict the pupil.
3. A contact lens is placed on the eye to focus the laser.
4. The ophthalmologist uses the laser to create small burns on the peripheral iris, which contract and pull the iris away from the drainage angle.
5. The procedure typically involves multiple laser applications around the iris.
6. Post-procedure eye drops may be administered to control inflammation and intraocular pressure.

Duration

Approximately 10-15 minutes per session.

Setting

Outpatient clinic or ophthalmologist's office.

Personnel

• Ophthalmologist
• Ophthalmic nurse or technician

Risks and Complications

• Mild discomfort or pain during the procedure
• Temporary inflammation or increased intraocular pressure
• Rare risks include bleeding, infection, or damage to the eye structures

Benefits

• Effective widening of the anterior chamber angle
• Prevention of acute angle-closure glaucoma
• Improved vision if iris position was previously obstructed

Recovery

• Use anti-inflammatory and pressure-reducing eye drops as prescribed.
• Avoid strenuous activity for a few days.
• Follow-up visits to monitor eye pressure and healing.
• Most patients can resume normal activities within a day or two.

Alternatives

• Medications to manage intraocular pressure
• Laser peripheral iridotomy
• Surgical procedures like trabeculectomy

Pros and Cons:

• Medications may have side effects and require lifelong use.
• Laser peripheral iridotomy is less invasive but may be less effective for some patients.
• Surgical options carry higher risks and longer recovery times.

Patient Experience

• Patients may feel mild discomfort or a slight burning sensation during the procedure.
• Post-procedure, there can be temporary blurry vision and light sensitivity.
• Pain is usually minimal and managed with topical medications.