Retina, Glaucoma & Cataract Lasers

First used over 30 years ago, lasers have become the standard of care for the treatment of many disorders. The laser produces a pure, high-intensity beam of light energy. This light can be focused to selectively treat the desired area and leave the surrounding tissues untouched. The energy that is absorbed creates a microscopic burn to join tissues together, destroy lesions, and open blocked passageways.

Laser Iridotomy

Lasers are used to treat eye problems such as diabetic retinopathy, retinal vein occlusions, age-related macular degeneration (ARMD), ocular histoplasmosis, retinal breaks and detachment, central serous chorioretinopathy (CSR), non- cancerous ocular tumors, and the effects of glaucoma.

With both retinal diseases and glaucoma, your eyes will almost always look and feel normal, even when severe problems are developing. In spite of the presence of conditions which threaten loss of vision, your sight may also remain normal for some period of time.

The only way to determine the need for laser surgery is through regularly scheduled eye exams and proper testing by our doctors. Maintaining your regular checkup allows the early detection of problems and the soonest possible treatment to preserve your valuable vision.

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Retina Laser Treatment

The following retina laser procedure is used in the treatment of diabetic retinopathy and macular degeneration:

• Focal Photocoagulation — In this procedure, the doctor precisely aims the laser at leaking blood vessels in the macula (a small, extremely important area in the back of the eye which provides sharp, central vision to see in fine detail, to read, and to drive). Treatment may prevent blurry vision caused by macular edema from getting worse.

Diabetic Retinopathy

• Photocoagulation — A special laser is used to create tiny burns under the retina. The burns seal the blood vessels to stop them from growing and leaking.
  
• Scatter Photocoagulation — Also known as panretinal photocoagulation. The doctor uses the laser to create a polka-dot pattern of hundreds of tiny burns in two or more treatments. If scatter photocoagulation is used prior to bleeding or retinal detachment having progressed too far, it reduces the risk of blindness from vitreous hemorrhage or detachment. Neovascular glaucoma is treated using the same procedure.
  
  Side effects of this procedure are generally minor. They can include a number of days of blurred vision following each treatment and the possible loss of peripheral (side) vision.

Macular Degeneration

• Photodynamic Therapy — Laser surgery can be used to treat certain types of wet macular degeneration. This is performed as a brief outpatient procedure in which a focused beam of light is used to slow or stop leaking blood vessels which damage the macula. A combination of a specific drug and laser treatment to slow or stop leaking blood vessels is used in a procedure called photodynamic therapy (PDT).

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Glaucoma Laser Treatment

• Laser Peripheral Iridotomy (PI) — Performed almost exclusively for patients with narrow angles, narrow angle glaucoma, or acute angle closure glaucoma, PI involves creating a minute opening in the peripheral iris directly to the anterior chamber of the eye. A successful result corrects the forward-bowing of the iris, opening the angle of the eye to allow aqueous flow and relieve internal pressure.
• Argon Laser Trabeculoplasty (ALT) — In this procedure, the doctor directs a laser beam into the trabecular meshwork, the primary aqueous drainage region of the eye. This serves to increase drainage of the aqueous fluid out of the eye, lowering the intraocular pressure.
• Selective Laser Trabeculoplasty (SLT) — This treatment represents a noteworthy advance in the surgical treatment of intraocular pressure (IOP) in patients with open-angle glaucoma. Unlike its precursor, argon laser trebeculoplasty (ALT), SLT is able to be repeated several times. ALT patients can receive two treatments within their lifetime. SLT patients are able to receive two treatments per year. This is because the laser beam circumvents surrounding tissue, leaving it completely undamaged.
• Endoscopic Cyclophotocoagulation (ECP) — ECP is performed on an out-patient basis. In this procedure, the ciliary body of the eye (located just behind the iris) which produces aqueous fluid is treated with the laser to decrease production of this fluid. This reduces pressure within the eye. This procedure is used in combination with cataract surgery or in those who have already had cataract surgery.

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Cataracts

Although cataracts never actually recur after cataract surgery, posterior capsule opacity is a condition often referred to as "secondary cataract". A haze of membrane may develop behind the intraocular lens (IOL) implant, essentially a scarring process of the membrane which had contained the natural lens of the eye.

• YAG Laser Capsulotomy — This "secondary cataract" condition is treated by the YAG laser capsulotomy, performed as a minor in-office or outpatient procedure. The eye is generally dilated prior to the procedure. A laser is then used to cut through the hazy capsule from behind the IOL implant. Entirely painless, it takes just a few minutes and results in no postoperative discomfort. An anti-inflammatory eye drop medication is usually recommended after the procedure. Patients may resume normal activities immediately. Some "floaters" can be expected, which will generally disappear within a few weeks. YAG laser capsulotomy almost always enables vision to be restored or improved.

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