Laser Iridotomy & Iridoplasty in Ahmedabad — Angle-Closure Glaucoma Treatment

Laser iridotomy and laser iridoplasty are quick, safe, and highly effective procedures used to treat narrow-angle and angle-closure glaucoma — a type of glaucoma where the drainage angle of the eye is blocked or at risk of closure.

These procedures are performed at Puja Eye Hospital, Naranpura, by Dr. Puja Sheth, a glaucoma specialist with a Fellowship of the International Glaucoma Society (FIGS).

Understanding Narrow-Angle and Angle-Closure Glaucoma

The eye continuously produces a fluid called aqueous humour, which drains out through a narrow channel called the drainage angle — the space between the iris and the cornea. In some people, this angle is anatomically narrow or becomes blocked by the iris, preventing the fluid from draining normally. This causes eye pressure to rise, which can damage the optic nerve.

Angle-closure glaucoma can develop slowly over years (chronic angle-closure) or occur suddenly as an acute attack — a medical emergency characterised by a sudden, severe rise in eye pressure accompanied by intense eye pain, headache, nausea, and blurred vision.
Laser procedures treat the underlying anatomical problem, preventing dangerous pressure rises before they occur.

Laser Peripheral Iridotomy (LPI)

Laser peripheral iridotomy is the primary treatment for eyes with narrow or closed drainage angles. During the procedure, a laser creates a tiny opening in the peripheral iris (the coloured part of the eye). This opening acts as a bypass channel, allowing aqueous fluid to flow more freely and equalising the pressure between the front and back chambers of the eye.

By relieving the pressure difference that pushes the iris forward and closes the angle, LPI prevents future episodes of angle closure and dramatically reduces the risk of an acute glaucoma attack.

Who Needs Laser Iridotomy?

Patients with anatomically narrow drainage angles at risk of closure, even without symptoms
Patients who have had an acute angle-closure glaucoma attack — as an emergency or post-emergency procedure
Patients with chronic angle-closure glaucoma
Fellow eyes of patients who have had an acute attack in one eye (the other eye is at high risk)
Patients with pigmentary glaucoma or plateau iris configuration, in selected cases

What to Expect During the Procedure

Laser iridotomy is performed as an outpatient procedure. Anaesthetic and pressure-lowering eye drops are applied before the procedure. You will sit at a slit lamp, and a special contact lens is placed on the eye to focus the laser precisely. The laser creates a small, nearly invisible opening in the iris in a matter of seconds.

The procedure takes approximately 5 to 10 minutes per eye. There is minimal discomfort — most patients experience only a brief sensation of pressure or a mild flash of light during the laser application.
After the procedure, anti-inflammatory eye drops are prescribed for a few days. Your eye pressure is checked after the procedure and you are monitored briefly before discharge. Most patients resume normal activities the same day or the following day.

Laser Iridoplasty

Laser iridoplasty (also called peripheral iridoplasty or ALPI — Argon Laser Peripheral Iridoplasty) is a complementary procedure used in specific situations where iridotomy alone is insufficient to open a very narrow or anatomically complex angle.

During iridoplasty, a ring of laser spots is applied to the peripheral iris, causing the iris tissue to contract and physically pull the iris away from the drainage angle — widening the angle and improving fluid drainage.

When Is Iridoplasty Used?

When the drainage angle remains narrow or partially closed after an iridotomy
In plateau iris syndrome — a condition where the iris is positioned in a way that continues to crowd the drainage angle even after iridotomy
As an emergency procedure to rapidly lower eye pressure in certain acute angle-closure situations

Are These Procedures Safe?

Both laser iridotomy and iridoplasty are very safe and well-established procedures with an excellent long-term safety record. Serious complications are uncommon. Mild, temporary side effects — such as a brief rise in eye pressure immediately after the procedure or minor inflammation — are managed with eye drops and resolve quickly.

Dr. Puja Sheth assesses the anatomy of each patient’s eye carefully before recommending a laser procedure and tailors the approach to the individual case.

Puja Eye Hospital- Glaucoma Eye Hospital

Protect Your Vision — Book a Glaucoma Evaluation Today

Call or WhatsApp Dr. Puja Sheth: +91 8780012121 Puja Eye Hospital, Naranpura, Ahmedabad | Mon–Sat: 9:30 AM – 4:30 PM

FAQs

Is laser iridotomy painful?

No. Anaesthetic drops are applied before the procedure. Most patients feel only a mild sensation or see a brief flash of light. The procedure is generally very well tolerated.

Will I need to stay in the hospital overnight?

No. Laser iridotomy and iridoplasty are outpatient procedures. You will be observed for a short period after the procedure to check your eye pressure, and then discharged the same day.

Does laser iridotomy cure glaucoma?

Laser iridotomy prevents future angle-closure attacks and is very effective at protecting the eye from dangerous pressure spikes. However, if glaucoma damage has already occurred, the nerve damage cannot be reversed. Some patients with angle-closure glaucoma also require ongoing pressure-lowering eye drops alongside laser treatment.

Can I see the opening that the laser makes?

The opening created by laser iridotomy is very small — typically less than 0.5 mm — and is located in the far periphery of the iris, usually hidden under the upper eyelid. Most patients cannot see it at all, and it does not affect vision.

How long does the effect of laser iridotomy last?

Laser iridotomy is considered a permanent procedure. The opening created in the iris typically remains patent (open) for life. In a small proportion of patients, the opening can close over time and may need to be retreated.