When Eye Drops Don’t Work: Glaucoma Treatment

Article Featured Image Glaucoma Laser Treatment

Glaucoma laser surgery and other procedures may be needed when eye drops fail to control glaucoma.

Eye drops are the most common treatment for glaucoma. Some eye drops help fluid drain from your eyes to lower eye pressure, while others lower eye pressure by reducing the amount of fluid your eyes produce.

When eye drops no longer work to reduce your eye pressure, surgery is the next step. In some cases, severe side effects from the eye drops make surgery the next step in treating glaucoma.

Glaucoma Laser Surgery

The first surgery most doctors use is laser surgery. There are three types of glaucoma laser surgery.

Argon laser trabeculoplasty (ALT): The laser is used to open clogs in your eye’s fluid so the fluid can drain out. Many doctors treat half the clogs first to see how well the procedure works for you. If it works well, then they will treat the other half of the clogs. ALT works in about 75% of people with the most common type of glaucoma.

Selective laser trabeculoplasty (SLT): If the ALT procedure doesn’t work for you, your doctor may use SLT in which a highly targeted low-level laser is used on the spots where there is pressure. SLT can be done a little at a time. In some cases, it is first laser surgical procedure used because it so specifically targets problem areas.

Laser peripheral iridotomy (LPI): This procedure is used when the space between your eye’s iris (colored part) and the cornea (clear outer layer) is too narrow. This extremely narrow space allows fluid and pressure to build up, so a laser beam is used to create a tiny hole in the iris so fluid has a new channel in which to drain.

Cyclophotocoagulation: This laser treatment is used on the ciliary processes in the are which are the part that produce the fluid (aqueous humor) that bathes the tissues in the front of the eye. Cyclophotocoagulation laser treatment works by shrinking the ciliary processes. The laser energy is used in micropulses to carefully target the tissue that is treated for shrinking.

Surgery is not a cure

For many people, laser surgery can free them from having to use daily eye drops. Laser surgery for glaucoma is an effective way to lower eye pressure and prevent further damage to the optic nerve. It is important to understand that laser surgery is not a cure for glaucoma and that the eye pressure lowering effect can wear off over time. However, laser treatment can be repeated. 




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Gregory Scimeca, M.D.
Ophthalmologist and Medical Director
The Eye Professionals

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