Selective Laser Trabeculoplasty (SLT)

SLT is used to help lower the intraocular pressure (IOP) in the treatment of glaucoma.  Just as with drops, the goal is to lower the IOP to a safe enough level to prevent further progression or vision loss. It is most often used in conjunction with your current anti-glaucoma drops. Occasionally, we may try to use SLT instead of an eye drop.

This procedure is performed as outpatient and has very few risks or complications.  It takes about 10 minutes and is painless.  SLT is effective in lowering IOP in about 75-80% of the time. The laser is a non-thermal (no heat) laser, so there is no risk of scarring.

Laser Iridotomy (YAG PI)

Laser Iridotomy is a procedure to create a small hole in the colored part of the eye, called the iris, with a laser. This procedure helps treat or prevent angle-closure glaucoma. If you have had an attack of angle-closure glaucoma, you may be in pain. The iridotomy is done as an emergency procedure in these cases.

This procedure is also done in some people who are at high risk for getting angle-closure glaucoma.

YAG Capsulotomy

During cataract surgery it is impossible to remove every cell because of their microscopic size and location. After cataract surgery these cells continue to produce the same protein material that they did before cataract surgery even though the lens is now gone. In about 50% of patients the film will migrate across the posterior capsule creating what eye doctors refer to as “capsule clouding” or “Posterior capsule opacification (PCO)”. This process usually takes a year or two to cause visual blurring, but it has been seen as early as three weeks following cataract surgery. It is easily corrected with the YAG laser.

The YAG uses laser light in a focused beam to make small openings in the posterior capsule to clear the clouded membrane. No anesthetic is required since the capsule has no nerve endings and therefore there is no pain. Once the capsule clouding is cleared it is usually permanent.

Lesion Removal

An eyelid papilloma is a rounded growth that protrudes from the upper or lower eyelid. These are very common lesions that most frequently develop in middle-aged and older patients. Papillomas are most often benign, but in rare cases may be precancerous or malignant. Many patients opt to have these lesions removed even if they pose no medical risk for cosmetic purposes or because they are a source of discomfort.

The standard of treatment for most eyelid papillomas (or other ocular bumps) is surgical excision. This procedure utilizes a device called the Ellman-Radiosurgery electrode loop to gently shave the lesion away (layer by layer) from the surface of the skin. The procedure typically takes less than 30 minutes. Some patients experience mild bleeding or bruising at the treatment site afterward, but these usually resolve within a few days.

Punctal Oclussion (Punctal Plugs)

When you blink, a film of tears spreads over the eye. This keeps the eye’s surface smooth and clear. The tear film is important for good vision. Normally, our eyes constantly make tears to stay moist. If our eyes are irritated, or we cry, our eyes make a lot of tears. But, sometimes the eyes don’t make enough tears or something affects one or more layers of the tear film. In those cases, we end up with dry eyes. Having a lot of tears in your eyes with dry eye might sound odd, but your eyes make more tears when they are irritated by dry eye.

One approach to treating dry eyes is plugging the openings to the tear ducts with tiny colligen plugs (punctal plugs). These plugs close the tiny opening (punctum) that you have in the inner corner of your upper and/or lower eyelids. The closure conserves both your own tears and artificial tears you may have added.

Typically, Comfortear Lacrisolve 180 Absorbable Punctum Plugs are used. They provide occlusion therapy of the lacrimal drainage system lasting from 6 months to 1 year.