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Laser Peripheral Iridotomy: What can you expect?

We know that any eye procedure can be an immensely intimidating experience when you don’t know what to expect. While it’s scary enough being told you have glaucoma, that’s made worse when someone mentions the word laser!

Luckily, the process can be a whole lot less daunting if you’re not going into the unknown.

What exactly is a laser peripheral iridotomy?

Laser peripheral iridotomy (commonly referred to as LPI) is a short procedure, usually performed on people with narrow angles or angle closure glaucoma. It involves using a laser beam to make a small hole in the iris of the eye (the coloured bit). The hole allows any fluid trapped behind the iris to drain more freely – which typically resolves the forwardly bowed iris and opens up the angle of the eye. 

What does the procedure involve?

The LPI procedure itself only takes a few minutes, but you’ll be asked to arrive at your ophthalmologist’s or eye surgeon’s office a little earlier in order to prepare your eyes. 

A technician will normally insert two kinds of drops – a local anesthetic, and an eye drop medication known as pilocarpine that constricts the pupils. Then you’ll have to wait for around half an hour, during which time your vision might be slightly blurred.

The LPI is completed in an office setting and requires no sedation, and it’s over in a matter of minutes. You’ll be seated at the laser with your chin and forehead rested forward, while the surgeon seated opposite will insert a special lens to prevent blinking and to magnify their view of the eye. You’ll need to look straight ahead for a series of laser shots in quite quick succession. A Glaucoma NZ member who has experienced an LPI described these laser shots as “starbursts of red light” and not painful, but slightly uncomfortable. 

If you’re having both eyes worked on, they’ll do the second one right after the other. And you’re done in a matter of minutes! You’ll be asked to wait a little while in the waiting room and then you’ll be ready to go home. If you’ve only had one eye treated, you may be able to drive yourself home. Otherwise, you’ll have to arrange to be picked up.

After the procedure

Before you leave, your eye surgeon might recommend anti-inflammatory eye drop medications for the next few days, but some people find they do not need any supplementary medication at all. They’ll also arrange a follow-up visit to monitor the results in the coming weeks and to double check that the procedure has been successful.

PI is known as an extraordinarily safe procedure and complications are very rare. Some patients might experience complications like bleeding in the eye, inflammation in the eye, occasional double vision, or transient pressure elevations. Luckily, these complications are usually very mild and do not result in permanent damage. To ease your concerns, make sure you have your eye surgeon’s contact details so you can ask them any questions about your experience. 

Often, people describe LPI as a ‘non-event’ – it involves a lot of worry, but once it’s finished you realise how minor the procedure is! Any procedure involving the eye is intimidating, but getting yourself prepared and knowing what to expect can make it a whole lot less scary. 

Wanting to know a bit more? View or print out our LPI fact sheet here

Information about other glaucoma surgeries can be found here. 

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