Peripheral iridotomy is an office procedure performed with lasers which involves making a hole in the periphery of the iris to create a communication between posterior chamber (the space between lens and iris) and anterior chamber (the space between iris and cornea).

It is mainly used in narrow angle glaucoma and some other conditions (e.g.: plateau iris) where the aqueous needs to flow freely from posterior chamber to anterior chamber.

Lasers Used for Iridotomy

There are many types of lasers used in laser iridotomy procedures. Nd:YAG laser, argon laser and diode lasers are used. To get better results, a combination of argon and Nd:YAG laser or a combination of diode and Nd:YAG laser can also be used.

Side Effects of Laser Iridotomy

The side effects of peripheral iridotomy procedure are minor. Bleeding may occur during the procedure which can easily be managed by applying pressure on the eye. A short-duration rise in IOP (intraocular pressure) and mild inflammation (uveitis) are common after the procedure. Both the spike in IOP and inflammation are controlled with eye drops for one to two weeks.

Success Rate of Laser Iridotomy

If the size of the iridotomy hole is adequate, the patient will no more need any eye medication to treat or prevent narrow angle glaucoma and its consequences. Most of the laser iridotomy procedures are successful. If for any reason the size of the hole is not adequate or is not patent, the procedure can be repeated to enlarge the iridotomy.

Iridectomy vs Iridotomy

Some ophthalmologists use the term laser ‘iridectomy’ instead of iridotomy but the term iridectomy is traditionally used when the opening in the iris is made with an eye surgery using scissors rather than with laser.

Laser Iridotomy Video

Here is a video which explains the laser iridotomy procedure:

Recovery After Laser Iridotomy

Since laser iridotomy does not require admission and the procedure takes only a few minutes, the recovery is fast. The patient may feel a little heaviness and glare after the procedure but that is only transient. The treatment prescribed after the procedure takes care of these symptoms.

Complications of Laser Iridotomy

Following is the list of possible but uncommon complications with laser iridotomy:

  1. Localized lens opacity (cataract)
  2. Corneal burn
  3. Retinal burn
  4. Prolonged inflammation (anterior uveitis)
  5. Closure of iridotomy

The above complications are not serious in nature and can be managed easily if noticed early. In good hands, such complications happen rarely.