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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 stabilize the pressure inside the eyes. 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) occupies a significant place.
The essence of the procedure
A laser-assisted iridotomy is a surgical micro-surgery during which a microscopic opening or several openings are created near the iris of an organ. This manipulation is needed to reduce pressure inside the eye, which prevents complications and loss of vision. According to statistics, in 90% of patients after manipulation, the problem disappears and intraocular pressure normalizes. The effectiveness of laser iridectomy is observed immediately after the operation.
Indications for the appointment of manipulation are: the diagnosis of primary and secondary closed glaucoma; mixed glaucoma; pupillary 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 for the procedure include clouding of the cornea and swelling of the eyes.
How to diagnose glaucoma?
To diagnose glaucoma, the doctor must measure the pressure in the eyes, then determine the field of view and examine the fundus. The ophthalmologist then pays attention to the symptoms the patient is talking about and reviews the medical history. 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 only be diagnosed in a protracted stage. If you experience pain in the eyes, narrowing of the field of vision or its deterioration at night, intolerance to bright light, you should immediately consult a doctor.
To prevent the disease, people should periodically measure the pressure inside the eyes (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 restored again. In the initial stages of glaucoma, the field of vision narrows, but there is no pain, while visual acuity does not change. Ophthalmologists advise to fight the disease with the help of laser iridotomy.
Preparing a patient for iridotomy with a laser
Before prescribing a micro-operation, the patient must pass a number of tests: biochemical analysis of blood plasma, general analysis of urine and blood, Rh factor, blood group, blood coagulability. If the patient has diabetes, be sure to consult with an endocrinologist. Sometimes an electrocardiogram, an HIV test, a chest x-ray is done. Often, the ophthalmologist recommends an additional consultation with an otolaryngologist and a general practitioner. If the operation is performed on a child, a pediatrician should be consulted.
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 as much as possible. It is necessary to bury medicines regularly and on time. A specialist may prescribe drops called Pilocarpine.
About risk groups
Patients at risk include:
- at the age of 40;
- with dark irises and swarthy skin;
- with a hereditary risk of the onset of the disease, when close relatives had glaucoma;
- with structural features of the organ of vision (dark irises, congenital features of the optic nerve, pathological ocular hypertension, thin cornea);
- who have mechanical trauma to the eye.
People with: diabetes mellitus and arterial hypertension, myopia, myopia, chronic inflammatory processes in the eyes (cataracts) can be afraid of the occurrence of glaucoma. With bronchial asthma, long-term 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 goals: opening the angle of the anterior chamber of the eyeball, preventing attacks of glaucoma that can lead to loss of vision, and normalizing intraocular pressure.
Laser iridectomy is performed by a specialist in stages. First of all, the doctor anesthetizes the organ of vision – instills it with a solution of Novocaine or Lidocaine. Next, a special goniolens is applied to the eye, which provides an overview of the eye during the manipulation. The doctor may use a Weiss or Abraham lens. Then a laser beam is directed to the selected area of the iris. The thinnest part of the iris with less visible vessels is selected. The burning of holes for the outflow of excess fluid begins.
The duration of the procedure varies from 10 minutes to 2 hours. The most optimal and safe size of iridotomy is 200-300 microns. To extract and excise the edge of the iris membrane, the doctor uses curved sterile scissors and special tweezers. After the manipulation, a small cutout in the form of a triangle remains on the edge of the iris.
Rehabilitation Features
Since laser iridectomy is bloodless and does not require suturing, there are practically no serious complications and side effects. After the operation, the patient does not experience pain and discomfort. To prevent “contagion” of the 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 pressure: Arutimol, Okumed, Proxodolol. In the postoperative period, a person should rest more, not play sports and not overdo it with physical activity. It is advisable not to go outside during bad weather: heavy rain, strong wind, fog or snow.
The patient must adhere to the rules of hygiene of the face and eyes; during the rehabilitation period, aggressive cosmetics should not be used. You can resume the use of cosmetics only after complete healing and restoration of the organ of vision. The eyes must rest, therefore, one should not go to bed late and interrupt during work to allow the organ to rest.
It is recommended to temporarily give up addictions and lead a healthy lifestyle. Be sure the patient must take medication according to the time and prescription of the ophthalmologist. If you experience the same symptoms, discomfort, pain syndrome or deterioration of vision, you should consult with your doctor.
The advantages of the operation are: painlessness; if there are no complications during the operation, then it takes only 15-20 minutes; the 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
A number of complications may indicate an unsuccessful procedure: clouding of the cornea, vascular damage, bleeding from the vessels, damage to the lens, the appearance of a “second pupil”, overgrowth of holes, visual defects, fusion in the area of holes, insufficient perforation depth. With fusion and overgrowth, the ophthalmologist will advise another operation.
To avoid the occurrence of side effects and complications, you need to undergo a thorough and reliable diagnosis, then choose a highly qualified specialist. After passing a series of tests and receiving the results, the doctor will be able to adhere to the technology of the procedure and avoid the appearance of unwanted complications in the future.
Eye disease, in particular, glaucoma, is a very serious disease that in a short period of time and almost asymptomatically can deprive a person of vision. Therefore, timely therapy and relief of glaucoma are very important. Laser iridotomy can quickly and painlessly prevent vision loss and stabilize intraocular pressure.
With careful implementation of the recommendations and advice of an ophthalmologist after surgery, the patient can count on a XNUMX% positive result. If the procedure does not bring the desired effect, you can repeat the therapy or turn to surgical methods of treatment.