Laser iridotomy

[ejp1978]

Hi,

I have just come back from my yearly check up at the hospital (I have eye pressures consistently above 26 but not over 30) and my local hospital advised that they only treat over 30 and will actively monitor me for any damage/changes etc which to date I have none, visual field still fully intact and no nerve damage as yet with these pressures. Also to keep you informed my left eye is severely amblyopic so basically I use my right eye for everything!

I saw a new Norwegian consultant who checked with a large glass contact lens that was stuck to my eye with a gel like substance to check my angles, he found they were narrow and advised I maybe at risk of an acute attack in the future. (My father had this attack and lost vision for a few hours - luckily it has been restored) I am 33 he is 67 and this happened to him on his 65th birthday! The consultant referred me to another specialist for a second opinion - who carried out another test to measure the size of my eyeball and said I have small eyes so therefore at a greater risk than before (all very confusing to me).

Basically now they have scheduled me in for a laser iridotomy and I have searched the internet and am petrified with the bad press I have read, the consultants basically told me medicines to lower my pressure will be no good for me and this is my only option!  What are the common side affects of this laser? am I likely to get this ditorted pupil others comment on and a white horizontal line! Some people even state do not have the procedure done but I dont see I have a choice. As you can appreciate I am so nervous to have this laser surgery on my good eye and they are lasering them both at the same time next week.

Any advice would be a huge help as the only side affect I was told was that my presures may increase for a short amount of time but they can control this.

If any doctors have any experience of this procedure or indeed anyone has had this laser performed on them what can I prepare myself to expect afterwards.

Thanks in advance for anyones comments.

Regards
Emma

[ejp1978]

How long before I find out if I do have this shadowing or arching?

[John C Hagan III, MD, FACS, FAAO]

Hope you don't have glare or shadowing from the location. My two close friends are both imminent glaucoma specialists and they use 3 and 9    

Good luck

[ejp1978]

Hi again, Well I have now had my procedure on both eyes and is was a little like electrodes going through my eyes! The surgeon performed the procedure at 12 o clock - his response to me was 3 o clock and 9 o clock are very old fashioned positions! I obviously dont have the expertise to discuss with him but I did ask and am worried I will now having this arching you mentioned but now the procedure is complete on both eyes and I have to live in hope they both were successful.  My question to you is should they have checked my eye pressures afterwards? - am I now at a great risk of a high IOP spike and if so how will I know this? My optic nerve was again perfect before the Iridotomy - I thought I would have been given eye pressure reducing drops - can you please advise if I should query this - my check up is in 4 weeks time? Is that ok to wait this long after this procedure? Thanks again Regards
Emma

[John C Hagan III, MD, FACS, FAAO]

Yes but not with a silicone IOL,  yes it is more difficult procedure than routine cataract surgery.
JCH MD

[kathryn241]

Can a silicone oil filled aphakic eye have an IOL placed?
Is this difficult to do?

[John C Hagan III, MD, FACS, FAAO]

You can raise the subject with the surgeons.  I believe most Eye MDs and glaucoma specialists now try to avoid the 12 oclock position which USE to be the most common place.   the tiny hole does not affect the ability of the iris to work opening ans shutting the pupil

JCH MD

[ejp1978]

Thank you so much for sharing your wisdom.  Can I ask if they do not perform them at 9 or 3 - do I need to request this? Also can you tell me if I will see the holes /damage caused to my Iris after the op, I have mid brown short sighted eyes.

Thanks again for your advice.

[John C Hagan III, MD, FACS, FAAO]

It is likely a great blessing that the second ophthalmologist found you have occludable angles. The risk of a laser iridotomy are relatively minor compared to having chronic angle closure glaucoma or an acute attack. It is also very likekly you IOP will go down after the LPI.

You can use the search feature and archives to read about laser iridotomies (iridectomies). It's also painless and generally can be done is less than a minute or two.

I make my openings at 3 or 9 oclock to minimize complaints of "arc-ing" post operative. Discuss with your surgeons. Again this new team has done you a real favor finding this problem.

JCH MD