Treatment Options

Glaucoma Treatment Options Overview

Treatments for glaucoma include eye drops, laser, and glaucoma surgery. Eye drops can lower IOP by decreasing aqueous humor production or increasing outflow. There are multiple laser procedures that can be done for glaucoma. Trabeculoplasty (MLT/SLT) laser treatment is used to “unclog” the trabecular meshwork drainage area. Laser Peripheral Iridotomy (LPI) creates a tiny whole in the iris, allowing the fluid to circulate freely in the eye. The last type of glaucoma-related laser is cyclophotocoagulation (CPC). This laser is used to reduce fluid production in the eye. Traditional glaucoma surgery refers to trabeculectomies and tube shunt devices. There is a newer area of MicroInvasive Glaucoma Surgery (MIGS). These procedures are designed to be safer yet still effective in lowering IOP. MIGS procedures include the iStent, XEN, and Gonioscopic Assisted Transluminal Trabeculotomy (GATT).

Learn More About Lasers

MLT/SLT

Micropulse Laser Trabeculoplasty (MLT) and Selective Laser Trabeculoplasty (SLT) are laser procedures performed to treat open angle glaucoma. The laser targets the trabecular meshwork, which is the site of most resistance to the outflow of aqueous humour. The laser causes localized tissue remodeling which “unclogs” the trabecular meshwork allowing increased drainage to lower intraocular pressure. While the in-office procedure is quick and painless, full effect of the laser may take several months. MLT and SLT differ in the wavelength of the treatment laser and upon examination the doctor will determine which laser would provide the greatest benefit for each situation. Additional treatments may be repeated over time if required. MLT and SLT are performed in clinic and patients can resume full activities the following day.

LPI

Laser Peripheral Iridotomy (LPI) is used to treat narrow angles as well as angle closure glaucoma. Angle closure glaucoma occurs due to a block between the iris and the lens, which prevents the aqueous humour from flowing between the anterior and posterior chambers of the eye. This results in a buildup of aqueous humour in the posterior chamber, which then causes the iris to bend forward, closing off the drainage system and causing the eye pressure to go up. LPI is a very quick in-office procedure that involves a using a laser to create a small hole in the iris. This allows the fluid to flow out of the posterior chamber and into the anterior chamber, preventing the spike in pressure and acute angle closure glaucoma. The LPI is performed in clinic under topical anesthesia and patients can resume full activities the following day.

CPC Laser

Cyclophotocoagulation (CPC) is a laser procedure used to treat glaucoma. This procedure “turns down the tap” in the eye to lower aqueous humor production, which lowers the intraocular pressure. The laser is applied through the sclera and onto the ciliary body. This ciliary body is the tissue that produces the aqueous humour (fluid in the eye). The laser partially destroys the ciliary body, reducing the secretion of aqueous humour and lowering intraocular pressure. The laser is performed under local anesthesia in the clinic or the procedure treatment room.

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