Glaucoma is a disease of the human visual apparatus, which occurs due to an increase in intraocular pressure and is accompanied by unpleasant symptoms. This disease should be constantly monitored and the pressure inside the eye should be stabilized. Until the end of the 19th century, it was impossible to cure glaucoma, but today ophthalmologists and surgeons use various methods of therapy, among which laser iridotomy (iridectomy) holds a significant place.
The essence of the procedure
Iridotomy with a laser is a surgical microoperation, during which a microscopic hole or several holes are created near the organ iris. This manipulation is needed to reduce the pressure inside the eye, which prevents the occurrence of complications and loss of vision. According to statistical data, in 90% of patients after the manipulation the problem disappears and the intraocular pressure normalizes. The effectiveness of laser iridectomy is observed immediately after surgery.
The indications for the purpose of the manipulation are: the diagnosis of primary and secondary closed glaucoma; mixed glaucoma; pupil block; a huge amount of pigments that negatively affect the release of fluid inside the eyes; complications after classical surgery; pathological changes in the anterior chamber of the organ. Contraindications of the procedure include corneal clouding and swelling of the eyes.
How to diagnose glaucoma?
To diagnose glaucoma, the doctor must measure the pressure in the eyes, further determine the visual field and examine the fundus of the eye. Then the ophthalmologist pays attention to the symptoms the patient is talking about and studies the history of the disease. Symptoms of glaucoma are: severe pain in the organ of vision, sudden pain in the forehead and temple, nausea, and occasionally vomiting.
The disease caused by high intraocular pressure is very dangerous because it can be diagnosed only in the protracted stage. In case of pain in the eyes, narrowing of the visual field or its deterioration at night, intolerance of bright light, you should immediately consult with the doctor.
To prevent disease, people should periodically measure the pressure inside the eye (at least once every six months). In the course of the disease, the nerve fibers of the retina and optic nerves are destroyed, which cannot be reconstructed. In the initial stages of glaucoma, the field of vision narrows, but there is no pain, and visual acuity does not change. Ophthalmologists advise to fight the disease with laser iridotomy.
Preparing the patient for iridotomy using a laser
Before prescribing a micro-operation, the patient must pass a series of tests: biochemical analysis of blood plasma, general analysis of urine and blood, Rh factor, blood type, blood clotting. If a patient has diabetes, be sure to consult with an endocrinologist. Sometimes electrocardiography, an HIV test, a chest x-ray are done. Often, the ophthalmologist recommends further consultation with the otolaryngologist and the therapist. If the operation is performed on a child, a pediatrician’s consultation is necessary.
3-4 days before the manipulation, the patient should undergo a course of miotics. They will help to narrow the pupil of the organ of vision. Bury drugs need to be regularly and on time. The specialist may prescribe a drop called "Pilocarpine".
About risk groups
The risk groups include patients:
- at the age of 40;
- with dark irises of the eyes and dark skin;
- with the hereditary risk of the disease when glaucoma was affected by close relatives;
- with structural features of the organ of vision (dark irises, congenital features of the optic nerve, pathological ocular hypertension, thin cornea);
- who experience mechanical injury to the eye.
People with: diabetes mellitus and arterial hypertension, myopia, myopia, chronic eye inflammation (cataract) can be afraid of glaucoma. In case of bronchial asthma, prolonged use of corticosteroids, diseases of the epidermis and diseases of the joints, glaucoma may develop.
Performing an operation
The procedure is needed to achieve several tasks: opening the anterior chamber angle of the eyeball, preventing glaucoma attacks, which can lead to loss of vision, normalization of intraocular pressure.
Laser iridectomy is performed by a specialist in stages. First of all, the doctor anesthetizes the organ of vision - it is instilled with a solution of Novocain or Lidocaine. Next, a special gonioliosis is applied to the eye, with the help of which the eye is reviewed during the manipulation. A physician may use a Weiss or Abraham lens. Then the laser beam is directed to the selected area of the iris. The thinnest part of the iris with less visible vessels is selected. Starts burning holes for the outflow of excess fluid.
The duration of the procedure varies from 10 minutes to 2 hours. The most optimal and safe size of iridotomy is 200-300 microns. The doctor uses curved sterile scissors and special tweezers to extract and excise the edge of the iris shell. After the manipulation there remains a small cutout in the form of a triangle on the edge of the iris.
Since laser iridectomy is bloodless and does not require stitching, there are almost no serious complications and side effects. After surgery, the patient does not feel pain and discomfort. To prevent infection by an infection, the doctor prescribes antibacterial drugs. These drugs are aimed at accelerating and simplifying the healing of the iris of the eye.
Eye drops can also be prescribed to stabilize the pressure: "Arutimol", "Okumed", "Proxodolol". In the postoperative period, a person should rest more, not play sports and not overdo it with physical exertion. It is advisable not to go out during bad weather: rain, strong wind, fog or snow.
The patient must adhere to the rules of hygiene of the face and eyes, during the rehabilitation period it is impossible to use aggressive cosmetics. You can resume the use of cosmetics only after complete healing and restoration of the organ of vision. The eyes should rest, so you should not go to bed late and be interrupted while working, to allow the body to rest.
It is recommended to temporarily abandon addiction and lead a healthy lifestyle. The patient must take medications according to the time and prescription of the ophthalmologist. If you experience the same symptoms, discomfort, pain, or deterioration of vision, you should consult with your doctor.
The advantages of the operation are: painlessness; if during the operation there are no complications, then it takes only 15-20 minutes; recovery period takes from 5 to 7 days; there is practically no pain and discomfort in the eyes after the manipulation in the postoperative period; affordable cost of laser iridectomy.
Complications and adverse reactions
An unsuccessful procedure can be indicated by a number of complications: corneal clouding, damage to blood vessels, bleeding from blood vessels, lens damage, the occurrence of a “second pupil”, overgrowth of holes, defects in vision, fusion in the area of holes, insufficient perforation depth. With fusion and overgrowing, the ophthalmologist will advise you to perform another operation.
To avoid the occurrence of side effects and complications, it is necessary to undergo a thorough and reliable diagnosis, then select a highly qualified specialist. After passing a series of tests and obtaining results, the doctor will be able to adhere to the technology of the procedure and avoid the occurrence of undesirable complications.
An eye disease, in particular, glaucoma, is a very serious disease that can deprive a person of sight in a short period of time and is almost asymptomatic. Therefore, timely treatment and relief of glaucoma are very important. Iridotomy with a laser can quickly and without pain, prevent vision loss and stabilize intraocular pressure.
With careful implementation of the recommendations and advice of the ophthalmologist after the operation, the patient can count on a one hundred percent positive result. If the procedure did not bring the desired effect, you can re-treatment or refer to surgical methods of treatment.