Understanding Laser Peripheral Iridotomy (LPI) for Narrow Angles

familyvisioncare
May 7
3 min read

If you've been informed that you have "narrow angles" or are at risk for angle-closure glaucoma, your eye care provider may recommend a procedure called Laser Peripheral Iridotomy (LPI). This quick, in office laser treatment can significantly reduce the risk of sudden, vision-threatening eye pressure spikes.

What Are Narrow Angles?

The eye maintains its shape and function through a continuous flow of aqueous humor, a clear fluid produced inside the eye. This fluid drains through a structure called the trabecular meshwork, located in the angle between the iris (colored part of the eye) and the cornea (clear front surface).

In some individuals, this angle is unusually narrow, which can impede fluid drainage and lead to increased intraocular pressure (IOP). This condition is known as narrow angles and can progress to angle-closure glaucoma, a serious eye disease that can cause permanent vision loss if not treated promptly.

What Is Laser Peripheral Iridotomy?

Laser Peripheral Iridotomy (LPI) is a minimally invasive procedure that creates a small hole in the peripheral part of the iris using a laser. This new opening allows the aqueous humor to bypass the blocked or narrow angle, facilitating proper fluid drainage and reducing IOP.

Why Is LPI Recommended?

LPI is often recommended for individuals with narrow angles to:

Prevent Acute Angle-Closure Glaucoma: By providing an alternative pathway for fluid drainage, LPI can prevent sudden increases in IOP.
Treat Existing Angle-Closure Glaucoma: In cases where angle-closure glaucoma has already developed, LPI can help alleviate the blockage.
Reduce the Risk in the Fellow Eye: If one eye has experienced angle closure, the other eye is at higher risk. LPI can be performed prophylactically on the unaffected eye.

What to Expect During the Procedure

LPI is typically performed in an outpatient setting and involves the following steps:

Preparation: Your eye will be numbed with anesthetic drops, and a special contact lens will be placed on your eye to focus the laser.
Laser Application: The ophthalmologist uses a laser to create a small hole in the peripheral iris. The procedure usually takes a few minutes.
Post-Procedure Care: You may experience mild discomfort, light sensitivity, or blurred vision temporarily. Anti-inflammatory eye drops may be prescribed to aid healing.

Benefits and Risks

Benefits:

Prevents Vision Loss: By reducing IOP, LPI helps prevent optic nerve damage and vision loss.
Quick Recovery: Most patients resume normal activities shortly after the procedure.
Minimally Invasive: LPI is a non-surgical, laser-based procedure with minimal discomfort.

Risks:

Temporary blurred vision or light sensitivity
Mild inflammation
Rarely, increased IOP or bleeding

It's essential to discuss potential risks and benefits with your eye care provider to determine if LPI is appropriate for you.

Visualizing the Impact of LPI

The following images demonstrate the anatomical changes before and after LPI:

Before LPI: The angle between the iris and cornea is narrow, restricting fluid drainage.

After LPI: The newly created hole in the iris allows better fluid flow, widening the angle.

Images courtesy of ResearchGate

Conclusion

Laser Peripheral Iridotomy is a safe and effective procedure for individuals with narrow angles, significantly reducing the risk of angle-closure glaucoma. If you've been advised to consider LPI, consult with your ophthalmologist to understand how this procedure can benefit your eye health.

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Note: Always consult with a qualified eye care professional to determine the best treatment options for your specific condition.