Last updated: 11/24/2009

Laser iridotomy/iridectomy

A person who is at risk for an acute episode of closed-angle glaucoma or who has already had emergency medical treatment for an attack may be treated with a laser iridotomy to reduce the level of fluid...

pressure in the affected eye. The drawback of a laser iridotomy in treating closed-angle glaucoma is that the hole may not remain open, requiring repeated iridotomies, a laser iridectomy, or a surgical iridectomy. In addition, laser iridotomies have a higher rate of success when used preventively rather than after the patient has already had an acute attack.

To perform a laser iridotomy, the ophthalmologist uses a laser, usually an argon or an Nd:YAG laser, to burn a small hole into the iris to relieve fluid pressure behind the iris. If the procedure is an iridectomy, the laser is used to remove a full-thickness section of the iris. The patient sits in a special chair with his or her chin resting on a frame or support to prevent the head from moving. The ophthalmologist numbs the eye with anesthetic eye drops. After the anesthetic has taken effect, the doctor shines the laser beam into the affected eye. The entire procedure takes between 10–30 minutes.

Conventional (surgical) iridectomy

Melanoma of the iris is usually treated by surgical iridectomy to prevent the tumor from causing secondary closed-angle glaucoma and from spreading to other parts of the body.

A surgical iridectomy is a more invasive procedure that requires an operating room. The patient lies on an operating table with a piece of sterile cloth placed around the eye. The procedure is usually done under general anesthesia. The surgeon uses a microscope and special miniature instruments to make an incision in the cornea and remove a section of the iris, usually at the 12 o'clock position. The incision in the cornea is self-sealing.