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

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.

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.

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.

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.

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.

Laser Peripheral Iridotomy (LPI) is a brief outpatient laser procedure in which a small opening is created in the peripheral iris (the coloured part of the eye) using a YAG laser. This opening creates an alternative pathway for aqueous humour to flow from the posterior chamber (behind the iris) to the anterior chamber (in front of the iris), relieving pupillary block — the mechanism underlying most cases of angle-closure glaucoma. LPI is recommended for: acute and chronic angle-closure glaucoma, narrow angles detected on gonioscopy before closure has occurred (prophylactic LPI), primary angle-closure suspects, and the fellow eye of a patient who has already had an acute attack. It is the standard first-line intervention for angle-closure disease and is available at Puja Eye Hospital, Naranpura, Ahmedabad.

Laser Peripheral Iridotomy (LPI) creates a small hole in the iris to relieve pupillary block – the main mechanism of angle closure. Laser Peripheral Iridoplasty (LPIP), also called argon laser peripheral iridoplasty (ALPI), uses a different laser (typically argon or diode) to place a ring of contraction burns on the peripheral iris, physically pulling it away from the drainage angle. Iridoplasty is used when angle closure persists after iridotomy due to mechanisms other than pupillary block — such as plateau iris syndrome, where the ciliary processes push the peripheral iris forward even after an adequate iridotomy. The two procedures may be used in combination. Dr. Puja Sheth selects the appropriate procedure based on gonioscopy findings, UBM (Ultrasound Biomicroscopy) results, and clinical examination.

Laser iridotomy is a non-incisional, outpatient procedure performed in the clinic – no operating theatre is required. The procedure at Puja Eye Hospital takes approximately 5–10 minutes per eye. After instilling topical anaesthetic and pupil-constricting drops, a contact lens is placed on the eye to focus the laser precisely on the peripheral iris. A YAG laser delivers a series of short, focused pulses that create a small, permanent opening (approximately 0.5 mm). The patient experiences a series of brief clicking sensations. There are no incisions, no injections, and no stitches. The patient returns home the same day after a brief post-procedure IOP check.

Most patients describe the experience of laser iridotomy as mild pressure or a brief stinging sensation with each laser pulse – not significant pain. Topical anaesthetic drops are used beforehand. Immediately after the procedure, patients may have mild blurring of vision, light sensitivity, and a dull ache around the eye, all of which typically resolve within a few hours. Anti-inflammatory eye drops are prescribed for 3–5 days post-procedure. Patients should arrange for someone to drive them home, as the pupil-constricting drops affect near vision. Dr. Puja Sheth reviews IOP at one hour post-laser to rule out a pressure spike, which can occasionally occur.

Laser iridotomy at Puja Eye Hospital carries a very low risk profile when performed by an experienced glaucoma specialist like Dr. Puja Sheth. Possible side effects include a transient IOP spike immediately after the procedure (managed with IOP-lowering drops given pre-laser), mild anterior chamber inflammation (controlled with drops), and, rarely, dysphotopsia — some patients notice a visual line or arc in their peripheral vision if the iridotomy opening is not fully covered by the upper eyelid. Serious complications such as lens damage or cataract are rare with modern YAG laser technique. Bleeding from iris vessels at the time of laser is common but self-limiting.

This depends on whether you had established glaucoma damage and elevated IOP before the iridotomy. If the procedure was performed preventively in a narrow-angle eye with no existing damage and normal IOP, drops may not be required long-term. If glaucoma damage or raised IOP was already present, additional treatment – medications or further laser/surgery – is typically needed alongside the iridotomy. At Puja Eye Hospital, Dr Puja Sheth reassesses IOP, gonioscopy, and OCT status 4-6 weeks after LPI to determine whether the drainage angle has opened adequately and whether additional intervention is necessary.

Yes. Laser Peripheral Iridotomy and Laser Peripheral Iridoplasty are available at Puja Eye Hospital, Naranpura, Ahmedabad, under the care of Dr. Puja Sheth, a dedicated glaucoma specialist. The clinic is equipped with a Zeiss YAG laser system. Puja Eye Hospital serves patients from across Ahmedabad and referring cities in Gujarat. Appointments can be scheduled directly at the clinic; urgent referrals for suspected acute angle-closure are accommodated as soon as possible given the time-sensitive nature of the condition.