Laser trabeculoplasty uses a very focused
beam of light to treat the
drainage angle of the eye. This surgery makes it
easier for fluid to flow out of the front part of the eye, decreasing pressure
in the eye.
Eye floaters are small moving spots that appear in your field of vision. They may be especially noticeable when you look at something bright, such as white paper or a blue sky.
Eye floaters can be annoying, but they generally don't interfere with your sight.
Occasionally a particularly large eye floater may cast a subtle shadow over your vision. But this tends to occur only in certain types of light.
Most of the time people learn to live with eye floaters and ignore them. And they often improve...
Argon laser trabeculoplasty (ALT) uses a laser
to open up the drainage angle of the eye.
trabeculoplasty (SLT) uses a lower-level laser to open the drainage angle of
For laser trabeculoplasty:
Eyedrops are put in the person's eye before or
after the procedure to decrease the amount of fluid in the eyes and prevent
elevation in eye pressure immediately after laser treatment.
special microscope (slit lamp) and lens (goniolens) are used to guide the laser
beam to the canals (trabecular meshwork) where fluid drains from the
The doctor makes small burns in the trabecular meshwork.
Some people feel a heat sensation in the eye during the
What To Expect After Surgery
Laser trabeculoplasty can be done
without the person being admitted to the hospital. The person needs to be
checked by the doctor within 2 hours of the surgery. The person will also need
to see the doctor for a follow-up exam as recommended.
Why It Is Done
Laser trabeculoplasty may be helpful
in treating people with
open-angle glaucoma that continues to get worse in
spite of medication treatment. It may also be helpful in treating older adults
with open-angle glaucoma who are not able to use medicines to treat the
Laser trabeculoplasty for open-angle glaucoma is
usually done before other surgical procedures are tried.
How Well It Works
Argon laser trabeculoplasty lowers
the pressure in the eye about 75% of the time.1
Research comparing ALT and the newer SLT has shown that SLT lowers pressure in
the eye about the same or slightly better than ALT.2
People usually need to continue taking medicine after laser surgery to keep
down the pressure in their eyes.1
over the pressure inside the eye may decrease as time passes. Argon laser
trabeculoplasty is often not effective when repeated. But experts believe that
SLT may be repeated because it uses a lower level of laser and causes less
scarring than ALT. SLT may be used if ALT fails to lower eye pressure. The
results of repeated laser surgeries are less predictable than the first
Decreased vision is usually a temporary problem unless
there is a significant rise in the pressure inside the eye. Very high pressures
inside the eye can lead to permanent vision loss.
If excessive scar tissue forms after laser
trabeculoplasty for open-angle glaucoma, other surgery may be needed.
Complications of laser trabeculoplasty are rare. The most common
complication of laser surgery for glaucoma is an increase in the pressure in
the eyes. The pressure may be normal immediately after laser surgery and rise
sharply within 1 to 4 hours after laser surgery. This complication can be
prevented by using apraclonidine or brimonidine before or after laser surgery,
especially in people with high intraocular pressure before laser
Other complications of laser surgery may include:
A brief period of inflammation of the colored
part of the eye (iris).
Cloudiness of the clear covering (cornea)
over the iris. This usually does not last long.
Blockage of the
drainage angle when the cornea and the iris stick
What To Think About
Laser trabeculoplasty is less
effective in people who have inflammatory glaucoma, a type of glaucoma caused
by an existing inflammation, and in young people who have developmental
defects. Laser trabeculoplasty is not done for patients who have closed-angle glaucoma.
The drop in pressure in the eye after laser surgery may
not be enough to prevent loss of eyesight in people with very high pressure who
have already lost some of their vision.
If damage to the optic
nerve continues after laser trabeculoplasty, other surgery may be
American Academy of Ophthalmology (2005).
Primary Open-Angle Glaucoma, Limited Revision (Preferred Practice Pattern). San Francisco: American Academy of Ophthalmology.
Also available online: http://www.aap.org/ppp.
Latina MA, et al. (2005). Selective laser trabeculoplasty. Ophthalmology Clinics of North America, 18: 409-419.
Primary Medical Reviewer
Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer
Christopher J. Rudnisky, MD, MPH, FRCSC - Ophthalmology
May 5, 2010
WebMD Medical Reference from Healthwise
May 05, 2010
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