Laser Peripheral Iridotomy (LPI) Laser Peripheral Iridotomy (LPI)
LPI is used for acute angle-closure glaucoma where the iris in the eye blocks the fluid from draining. This procedure makes an opening in the iris which allows the fluid to drain.
Argon Laser Trabeculoplasty (ALT)
ALT is used primarily for open-angle glaucoma. A laser beam is aimed at the opening of the fluid channel which helps the fluid drain.
Selective Laser Trabeculoplasty (SLT)
SLT is the newest type of laser surgery. The SLT uses a combination of frequencies that allow the laser to work at very low levels that allow the procedure to be safely repeated many times. The SLT treats specific cells and leaves the mesh-like drainage canals surrounding the iris intact. This may be an alternative for those who have been treated unsuccessfully with traditional lasers or with pressure-lowering eye drops.
Trabeculectomy is a conventional microsurgery. It is a successful technique used in cases of acute, chronic, congenital and secondary glaucoma. Before surgery begins, a local anesthetic, along with a medication to help you relax, is given to prevent you from feeling any discomfort during the procedure. A tiny opening is made in the sclera (the white part of the eye) with a small surgical tool. This new opening allows the intraocular fluid to bypass the clogged drainage canals and flow out of this new, artificial drainage canal. In chronic glaucoma, a small piece of the iris is often removed first to prevent any future problem with acute glaucoma. The tissue over the opening rises to form a little blister called a bleb on the clear conjunctiva. The bleb will be a slightly different color than the white area around it. Doctors look for the bleb to make sure that fluid is draining out of the new opening. Dr. Liang performs this surgery on an outpatient basis and it is performed at an Ambulatory Surgery Center.
Optical Coherence Tomography
OCT is an innovative scanning system that produces highly detailed images of the retina, the innermost layer of the interior of the eye. This instrument can “see” below the surface of the retina to examine the retinal layers. These pictures allow Dr. Liang to identify and treat problems in the best possible way.
With the OCT, Dr. Liang can detect glaucoma and other abnormalities of the retina, including age-related macular degeneration (AMD), detached retina, macular holes, diabetic macular edema and more. The OCT never touches the eye, so there is no discomfort and requires only minutes to scan the eye.
The Trabectome, an FDA-cleared device for minimally invasive surgical treatment of open-angle glaucoma, is designed to improve fluid drainage from the eye and balance intraocular pressure (IOP). Trabectome can help to stabilize optic nerve health and minimize further visual field damage by gently unblocking pressure with a three-step process that takes approximately 30 minutes.
iStent® Trabecular Micro-Bypass is the first micro-invasive glaucoma surgery (MIGS) device to safely reduce pressure in the eye by creating a permanent opening in the drainage network around the eye (called the trabecular meshwork). The iStent® is the smallest ever FDA-approved medical device. It’s a snorkel-like tube that’s inserted into the trabecular meshwork during cataract surgery. No additional procedure is necessary. Once inserted, iStent® helps manage the flow of aqueous humor – the fluid in your eye – so that excess pressure in the eye is reduced and the danger of permanent damage is lessened.