Laser iridoplasty reshaping the iris to open the angle in the eye.

Laser Iridoplasty: Can It Save Your Vision?

Kai Mendoza in Health & Wellness June 2025 • 4 min read.

"Exploring the enduring effects of laser iridoplasty as a vision-saving treatment for angle closure"

For individuals with primary angle closure (PAC), a condition where the drainage angle in the eye narrows or closes, leading to increased intraocular pressure, laser iridoplasty (LI) emerges as a ray of hope. This procedure becomes particularly relevant when traditional iridotomy—creating a hole in the iris to improve fluid flow—fails to fully open the angle. LI offers a different approach, reshaping the iris to widen the angle and reduce pressure.

The effectiveness of laser iridoplasty lies in its dual action: thinning the iris tissue and causing both circumferential and radial contraction. Imagine the iris as a curtain; LI essentially pulls this curtain back, away from the trabecular meshwork, the eye’s drainage system. By doing so, it aims to restore the natural outflow of fluid, preventing the buildup of pressure that can damage the optic nerve.

While the immediate benefits of LI have been well-documented through spectral domain anterior segment optical coherence tomography (ASOCT), the long-term durability of its effects has been a subject of ongoing discussion. Now, let’s delve into the lasting impact of laser iridoplasty and what it means for those seeking to preserve their vision.

The Enduring Impact of Laser Iridoplasty

Laser iridoplasty reshaping the iris to open the angle in the eye.

A recent study published in Clinical & Experimental Ophthalmology sheds light on the enduring effects of laser iridoplasty. Researchers reviewed the electronic health records of 18 sequential patients (23 eyes) with PAC who underwent LI after peripheral iridotomy failed. These patients were followed for four years using Spectralis ASOCT to monitor changes in their eyes.

The procedure itself involves using an 810-nm diode laser to create gentle, sustained iris contraction. Laser spots are strategically placed around the iris to achieve the desired reshaping effect. ASOCT imaging, performed in a dark room, allows doctors to precisely measure key metrics, including iris thickness (IT350) and angle opening distance (AOD500).

Key measurements tracked during the study included:

Intraocular Pressure (IOP)
Glaucoma Medications
Iris Thickness at 350 µm from the scleral spur (IT350)
Angle Opening Distance at 500 µm (AOD500)

The study revealed significant changes in these metrics following LI. The mean pre-LI IT350, which was 306 µm, reduced to 190 µm at the first visit after LI. After four years, it was 210 µm. Similarly, the mean pre-LI AOD500 increased from 69 µm to 239 µm at the first visit after LI and was 256 µm at the final follow-up. The mean IOP also dropped from 14.6 mmHg before LI to 12.7 mmHg at the final follow-up. Gonioscopy, unfortunately, was not consistently recorded, so there is no data about the change in the observed angle. These results suggest that LI can provide lasting improvements in angle opening and IOP control.

Making Informed Decisions

While this study provides valuable insights into the long-term effects of laser iridoplasty, it’s important to recognize its limitations as a retrospective analysis. Nevertheless, the findings offer a clear illustration of LI's potential to provide lasting opening of the iridocorneal angle. For those seeking alternatives to lens extraction, LI presents itself as an excellent option, especially in lower-risk situations. However, only a qualified ophthalmologist can determine the best course of action based on individual circumstances.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1111/ceo.13149, Alternate LINK

Title: The Enduring Effect Of Laser Iridoplasty

Subject: Ophthalmology

Journal: Clinical & Experimental Ophthalmology

Publisher: Wiley

Authors: Dickson Wong, Jesse Gale, Anthony P Wells

Published: 2018-02-23

Everything You Need To Know

What is laser iridoplasty, and when is it considered as a treatment option?

Laser iridoplasty (LI) is a procedure used to treat primary angle closure (PAC) when the drainage angle in the eye narrows or closes, leading to increased intraocular pressure. It's considered when a traditional iridotomy doesn't fully open the angle. LI reshapes the iris to widen the angle and reduce pressure. This differs from lens extraction, which is another surgical option to manage angle closure by removing the lens to create more space in the anterior chamber. While both aim to reduce intraocular pressure, they address the issue through different mechanisms.

How does laser iridoplasty actually work to improve the drainage angle in the eye?

Laser iridoplasty works by thinning the iris tissue and causing both circumferential and radial contraction. This effectively pulls the iris away from the trabecular meshwork, which is the eye’s drainage system. By reshaping the iris with an 810-nm diode laser, LI aims to restore the natural outflow of fluid, preventing the buildup of pressure that can damage the optic nerve. This reshaping is achieved by strategically placing laser spots around the iris to achieve the desired effect.

What specific measurements are used to determine if laser iridoplasty is effective, and what do changes in these metrics indicate?

Key measurements used to track the effectiveness of laser iridoplasty include Intraocular Pressure (IOP), the amount of Glaucoma Medications needed, Iris Thickness at 350 µm from the scleral spur (IT350), and Angle Opening Distance at 500 µm (AOD500). Spectral domain anterior segment optical coherence tomography (ASOCT) is used to obtain these measurements. Changes in these metrics after LI indicate whether the procedure is successfully improving angle opening and controlling IOP. Gonioscopy data about the change in the observed angle was not collected. The study revealed that IT350 reduced after LI, and AOD500 increased.

What does current research say about the long-term effectiveness of laser iridoplasty based on clinical studies?

A study published in Clinical & Experimental Ophthalmology followed patients with primary angle closure (PAC) who underwent laser iridoplasty (LI) after peripheral iridotomy failed. The study tracked changes in Intraocular Pressure (IOP), the amount of Glaucoma Medications needed, Iris Thickness at 350 µm from the scleral spur (IT350), and Angle Opening Distance at 500 µm (AOD500) over four years using Spectralis ASOCT. The results indicated that LI can provide lasting improvements in angle opening and IOP control. Because the study is retrospective, its findings should be taken with caution.

Why is laser iridoplasty considered a vision-saving treatment, and what are its potential long-term benefits for maintaining vision?

Laser iridoplasty (LI) is considered a vision-saving treatment because it addresses primary angle closure (PAC), a condition that can lead to increased intraocular pressure and damage to the optic nerve. By reshaping the iris and improving fluid outflow through the trabecular meshwork, LI aims to prevent the progression of glaucoma and preserve visual function. The long-term impact of LI can help maintain healthy intraocular pressure and reduce the need for glaucoma medications. The reduction of the Iris Thickness and increasing the Angle Opening Distance can improve a patients vision.