How long does laser treatment for Glaucoma last?
Question by Oatmeal: How long does laser treatment for Glaucoma last?
I have heard that the pressure may begin to increase after a time. I’m wondering how much time that would be and what would be the next step? Would you get another laser treatment or would you get the conventional surgery?
Best answer:
Answer by crowfeathers
Laser iridotomy for angle-closure glaucoma may close in the early period after the laser is performed, but can easily be opened up. In a few patients, late closure occurs, and is also easily opened. In ALT for open-angle glaucoma, about 90% of patients get an initial response and 80% have a response at the end of one year. The procedure wears off at a rate of approximately 10% per year, so that somewhat less than half of patients treated are still under control at the end of five years. However, this certainly is a long enough period of time to make it worthwhile undergoing the procedure.
The trabecular meshwork runs circumferentially around the eye for 360 degrees. Many ophthalmologists treat 180 degrees, using 50 spots, and if the pressure comes under control, stop at that point. Then, if and when the initial treatment wears off, the second 180 degrees can be similarly treated. Some ophthalmologists believe in treating the entire 360 degrees initially. Repeat ALT, in which an additional treatment superimposed upon the first area of treatment is applied, has been advocated. I very rarely do this. Many patients can get a rise in IOP instead of a lowering. If the initial treatment of 360 degrees (whether performed in one session or two sessions) is insufficient or the effect wears off, I feel that the next step should be surgical intervention.
What do you think? Answer below!
It really depends on the amount damage you have to your optic nerve already, how fast it is progressing, and how high your continued pressure is with medication, such as beta blockers (given via eye drops).
If you have had laser treatment already, you are *generally* fine for a few years. The range may be 3 years-10 years, with some people needing more sooner, and some later. The only way to know how your condition is progressing is to keep regular check ups with your ophthalmologist.
Depending on how fast your condition is progressing and other factors, your doctor may recommend another laser treatment, or surgery.
However, surgery is seen *generally* as a last resort, although in some cases it can be the first choice, depending on the subtype of glaucoma or if the person cannot tolerate or has contraindication to the medications used to treat glaucoma.
The reason for this I believe is because scarring and damage can occur with excess surgery, leading to more problems and the fact that additional surgery will no longer improve the condition at this point, and may make it worse.
I would not panic yet, just be sure to keep in close touch with your doctor.