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

Laser Iridoplasty: Can It Save Your Vision?

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Kai Mendoza in Health & Wellness April 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.

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