Argon Laser Trabeculoplasty (ALT)
Laser surgery has become increasingly popular as an intermediate step between drugs and traditional glaucoma surgery. The most common type of laser surgery performed for open-angle glaucoma is called Argon Laser Trabeculoplasty (ALT). The objective of the surgery is to help fluids drain out of the eye, reducing intra-ocular pressure that can cause damage to the optic nerve and loss of vision.
Although your eye care professional may suggest ALT surgery at any time, it is often performed after trying to control intra-ocular pressure with medicines. In many cases, you will need to keep taking glaucoma medications even after ALT surgery.
ALT is for those:
- who have been diagnosed with glaucoma
- whose doctor has determined that ALT is appropriate for controlling their intra-ocular pressure
What to expect on procedure day:
Your treatment will be performed in a specially equipped laser room. It does not require a surgery center. Once you have been checked in and settled comfortably, drops will be used to numb your eye; no injections or needles are used. When your eye is completely numb, an eyelid holder will be placed between your eyelids to keep you from blinking during the procedure.
Your doctor will hold up a special lens to your eye as a high-energy beam of light is aimed at the lens and reflected onto the trabecular meshwork inside your eye. You may see flashes of bright green or red light. Your doctor will make 50-100 evenly-paced laser applications in 10-15 minutes. This will be done in one or two treatment sessions. The laser beam will cause some areas of your eye’s drain to shrink, resulting in adjacent areas stretching open to permit the fluid to drain faster. You will not feel any pain during the procedure.
Your eye pressure will be checked shortly after your procedure and drops may be prescribed to alleviate any soreness or swelling inside your eye. You should relax for the rest of the day. Follow-up visits are necessary to monitor your eye pressure. While it may take a few weeks to see the full pressure-lowering effect of this procedure, during which time you may have to continue taking your medication, many patients are eventually able to discontinue some of their medications. Most patients resume normal activities within a few days.
The effect of the surgery may wear off over time. Two years after ALT surgery, the pressure from glaucoma increases again in more than half of all patients. Serious complications with ALT are extremely rare, but like any surgical procedure, it does have some risks. You will be given additional information about the procedure that will allow you to make an informed decision about whether to proceed. Be sure you have all your questions answered to your satisfaction.