YAG PI LASER TREATMENT
HOW DOES ACUTE NARROW ANGLE GLAUCOMA OCCUR ?
First let us try and explain the structure of the eye. The ciliary processes makes the fluid that occupies the front part of the eye. These ciliary processes are attached to the ciliary body. And this ciliary body is present behind the iris which is the brown part of your eye. Acute narrow angle glaucoma occurs in patients who have a shallow space between the cornea at the front of the eye and the colored iris that lies just behind the cornea. This space is known as the anterior chamber.
As the eye ages, the natural lens behind the pupil grows thicker. Also as the eye ages the pupil becomes smaller, restricting the flow of fluid to the drainage site. The drainage site is at a place between the back part of the cornea and front part of the iris. It’s also called the angle. The actual name of the structure that drains the fliud from the eye is called the trabecular meshwork.
If the pupil becomes smaller and the lens thicker there may arise a situtation where the round pupil presses against the lens which is just behind it. If this happens, fluid flow from behind the iris through the pupil to the front of the iris stops. The fluid can build up behind the iris, pushing the iris forward like a sail of a boat. This ballooning of the iris can block the channel (angle) that allows aqueous fluid to drain. Because of this closed angle the fluid outflow from the eye stops. A rapid rise in intraocular pressure can occur.
This rapid rise in pressure is known as acute angle closure glaucoma. If left untreated this acute rise of eye pressure can significantly damage the optic nerve. This would result in irreversible loss of vision. Symptoms of acute angle closure glaucoma are blurring of vision, redness and severe pain.
WHO UNDERGOES YAG PI LASER EYE SURGERY ?
Sometimes we see narow angle suspects where the angle appears narrow and pressure is borderline. There may also be positive family history of glaucoma eye disease. In these patients too, Yag laser treatment may be done. These patients are known as primary angle closure suspects. In other words having a narrow angle is a risk factor for developing acute angle closure glaucoma.
HOW DOES THIS LASER TREAT THIS TYPE OF GLAUCOMA ?
HOW IS GLAUCOMA LASER SURGERY DONE ?
Once that is done, the patient sits in front of the laser machine and places his or her chin on the chin rest. Anaesthetic drops are put in the eye to numb the eye and then a contact lens is placed on the surface of the eye. This may sound scary but because of the numbing drops this step does not hurt.
Then the doctor looks for spot on the iris which is thin. Once the spot is found the lens is rotated to make sure it is in focus and the laser beam is fired. Usually 2-4 shots may be needed. The doctor knows that its done when he sees a burst of iris pigment flow into the Anterior chamber. Eye doctors and glaucoma specialists also call this as pigment dispersion into the anterior chamber.
The entire procedure takes 5 to 7min for each eye. It is an outpatient procedure and a stand-alone procedure. Nothing else is needed at that point in time.
WHAT ARE THE PRECAUTIONS AFTER THE YAG PI ?
Once the laser treatment is done the patient is prescribed certain eye drops. These eye drops are antiinflammatory and help in reducing the inflammation that occurs due to the laser. As explained earlier, your eye doctor has caused an injury to your eye with that laser and the body is going to react to it. The drops will help in reducing that reaction.
Sometimes, because of a small amount of bleeding the vision may become blurred. Even if this happens there is nothing to worry about as the blood clears up in a week and vision should return to normal.
CAN THE LASER PROCEDURE BE NEEDED AGAIN ?
WHAT HAPPENS IF THE PRESSURE IS NOT CONTROLLED AFTER THE LASER ?
Frequently Asked Questions
You may feel a slight pain at the time of laser. One could compare it to a mosquito bite. It is bareable and usually is not an issue.
It takes 2-5 minutes per eye to perform Laser.
As we apply anaesthetic drops before doing it there is no pain. Occasionally a mild stinging sensation may be experienced.
A drop is prescribed to reduce the inflammation in the eye. The patient is required to come the next day to get the eye pressure checked and also to check the laser opening made in the eye.
The procedure is done in the OPD itself not in the ot. So it is very convenient for the patient.
As it is a very small opening that too at the periphery of the eye it cannot bee seen. Also it is done in the upper half so it gets covered by the upper eyelid.