What is Laser Trabeculoplasty (LTP) And When is it Indicated?

In open angle glaucoma, the drainage site (the trabecular meshwork) for the internal fluid of the eye does not function properly.  The build-up of fluid causes the pressure inside the eye to increase.  Laser Trabeculoplasty (LTP) attempts to improve drainage of the fluid of the eye thereby lowering intraocular pressure.  During LTP, spots from the laser beam are directed at the trabecular meshwork.  If the procedure is successful, these spots open up the meshwork to allow better fluid drainage. LTP is generally recommended for patients with open angle glaucoma that continues to progress despite the use of medications.  The decision to proceed with laser treatment depends on the type and stage of glaucoma, as well as other factors.

What to Expect During LTP: 

The procedure is an outpatient procedure performed here at the Family Eye Care Center, by Dr. Dwayne Baharozian.  You will be seated at a slit lamp just as you are for a regular examination.  The laser is attached to the slit lamp.  Before the procedure, numbing drops will be administered to each eye.  A special contact lens is then placed on the eye to be operated on in order to prevent blinking and to focus the laser beam.  The laser beam will then be directed at the meshwork, and 40 to 60 spots will placed in just a few minutes.  Most people experience only minimal, if any, discomfort.  After the procedure, you will probably have blurry vision and some irritation that will go away within the day.  Most people will need and anti-inflammatory eye drop four times a day for 4 days following the laser, in addition to their regular glaucoma medications.  Only one half of the meshwork is treated at one time, and a second laser procedure may be required at a later date if the pressure is not sufficiently lowered.  

Will the Laser Cure My Glaucoma?

The laser treatment will help control but will not cure glaucoma. Any vision already lost prior to the laser treatment will not return. The laser procedure only lowers your eye pressure.  The goal of the laser procedure is to lower the eye pressure in order to stop or at least, slow down your vision loss.  Sometimes, this goal cannot be achieved.

Can I Stop My Glaucoma Drops After the Laser?

It takes four weeks to determine the full effect of the laser treatment.  You will need totake all your glaucoma drops in the immediate period after the laser treatment.  Once the full effect is known, it is sometimes possible to decrease the number of glaucoma eye drops you take.  The need for glaucoma eye drops varies from individual to individual and is determined by your type of glaucoma and the rate the condition is progressing.

What Are Some Risks of Laser Surgery?

All laser procedures have some risks.  Laser treatment is not done unless the benefits outweigh the risks.  Risks include but are not limited to: inflammation, eye pressure elevation and vision loss.  In general, serious risks are not common and loss of vision after a laser treatment is usually from progression of glaucoma and not from the laser itself. 

Does the Laser Procedure Work For Everyone?

LTP works most effectively with patients who have pigmentary glaucoma or pseudoexfoliation glaucoma.  Although the laser works in the majority of people to lower eye pressure, it does not work for everyone. Even if the laser procedure is successful, its effect is not permanent. Sometimes, the laser treatment can control pressure for up to 3 or 5 years.