Glaucoma and glaucoma revision surgery

NARROW-ANGLE GLAUCOMA AND Acute angle-closure glaucoma

There is a congenital predisposition to a narrow anterior chamber angle. With increasing age this angle can be further narrowed by swelling of the lens.
This situation is a high-risk factor for the occurrence of angle closure glaucoma. The intraocular pressure rises noticeably in the short term due to the obstruction of the aqueous humor drainage, and acutely endangers vision.

An iridotomy with the help of the Nd:YAG laser serves to prevent and also to treat an acute angle closure glaucoma. A small hole in the iris is created by a few laser shots. The aim is to enable a direct outflow of aqueous humor from the posterior chamber of the eye into the anterior chamber of the eye through this opening and thus to remove the blockage in circulation. Due to their small size, the holes can also close again in the course of the procedure; in this case a new treatment may be necessary.


In glaucoma, the optic nerve slowly atrophies unnoticed due to chronically increased eye pressure. Untreated, this can lead to blindness. Often no cause for the pressure increase is found. The eye pressure can be lowered by medication that reduces the production of aqueous humor or by surgery which improves the outflow.

Alternatively, a selective laser treatment (SLT) of the so-called trabecular meshwork, the drainage apparatus of the eye, offers an improvement of the outflow and a certain reduction of the eye pressure up to 30% can be achieved. Since the laser only works on the pigment in the chamber angle and the actual tissue in the chamber angle (so-called trabecular meshwork) is not stressed by the laser, the therapy can be repeated if necessary. However, the previously required medication must be continued until the therapy is successful (4 to 6 weeks). SLT is a painless procedure that can be performed without special preparation.


The laser treatment is carried out on an outpatient basis, a dilation of the pupil is not necessary. Using a slit lamp, the ophthalmologist can focus the laser beam specifically on the iris or trabecular meshwork, and with a few shots create an opening at the top of the iris for iridotomy or stimulate the pigment cells in the chamber angle.

The treatments are painless and invisible from the outside. Special precautions after the treatments are not necessary.