Laser/Light Application in Ophthalmology: Control of Intraocular Pressure

  • Krishna B. Patel
  • Michael C. Giovingo
  • Ramez I. Haddadin
  • Douglas J. Rhee


The term “glaucoma” refers to a group of disorders that share common phenotypes. There are over 20 different subtypes of glaucoma. The glaucomas are defined by a characteristic loss of retinal ganglion cell axons leading to a progressive optic neuropathy that is related to intraocular pressure (IOP). If untreated, glaucoma can cause visual disability and even blindness. Although elevated intraocular pressure (IOP) is no longer formally part of the definition, it is recognized as the major risk factor for progression of the disease.


Glaucoma Intraocular pressure Laser applications Laser iridotomy Laser iridoplasty Laser trabeculoplasty Cyclophotocoagulation 

Further Reading


  1. 1.
    Ramulu PY, et al. American Academy of Ophthalmology: utilization of various glaucoma surgeries and procedures in Medicare beneficiaries from 1995 to 2004. Ophthalmology. 2007;114(12):2265–70.CrossRefPubMedGoogle Scholar
  2. 2.
    Schwartz K, Budenz D. Current management of glaucoma. Curr Opin Ophthalmol. 2004;15(2):119–26.CrossRefPubMedGoogle Scholar
  3. 3.
    Stamper RL, et al. Diagnosis and therapy of the glaucomas. St. Louis, MO: Mosby; 1999. p. 521–54.Google Scholar
  4. Angle Closure Glaucoma Treatments

    1. 4.
      Liebmann JM, Ritch R. Laser surgery for angle closure glaucoma. Semin Ophthalmol. 2002;17(2):84–91.CrossRefPubMedGoogle Scholar
    2. 5.
      Ritch R, et al. Diagnostics and surgical techniques – Argon Laser Peripheral Iridoplasty (ALPI): an update. Surv Ophthalmol. 2007;52(3):279–88.CrossRefPubMedGoogle Scholar

    Trabeculoplasty: Basic Science

    1. 6.
      Bradley JMB, et al. Mediation of laser trabeculoplasty-induced matrix metalloproteinase expression by IL-1B and TNFa. Invest Ophthalmol Vis Sci. 2000;41:422–30.PubMedGoogle Scholar
    2. 7.
      Latina MA, Park C. Selective targeting of trabecular meshwork cells: in vitro studies of pulsed and cw laser interactions. Exp Eye Res. 1995;60(4):359–71.CrossRefPubMedGoogle Scholar
    3. 8.
      Melamed S, Epstein DL. Alterations of aqueous humor outflow follow- ing argon laser trabeculoplasty in monkeys. Br J Ophthalmol. 1987;71:776–81.CrossRefPubMedPubMedCentralGoogle Scholar
    4. 9.
      Melamed S, et al. Short-term effect of argon laser trabeculoplasty in monkey. Arch Ophthalmol. 1985;103:1546–52.CrossRefPubMedGoogle Scholar
    5. 10.
      Rodrigues MM, et al. Electron microscopy of argon laser therapy in phakic open-angle glaucoma. Ophthalmology. 1982;89:109–210.CrossRefGoogle Scholar

    Trabeculoplasty: Clinical

    1. 11.
      Birt CM. Selective laser trabeculoplasty retreatment after prior argon laser trabeculoplasty: 1-year results. Can J Ophthalmol. 2007;42:715–9.CrossRefPubMedGoogle Scholar
    2. 12.
      Bovell AM, et al. Long term effects on the lowering of intraocular pressure: selective laser or argon laser trabeculoplasty? Can J Ophthalmol. 2011;46(5):408–13.CrossRefPubMedGoogle Scholar
    3. 13.
      AMV B, et al. Laser trabeculoplasty – argon or diode. Aust NZ J Ophthalmol. 1993;21(3):161–4.Google Scholar
    4. 14.
      Chung PY, et al. Five-year results of a randomized, prospective, clinical trial of diode vs argon laser trabeculoplasty for open-angle glaucoma. Am J Ophthalmol. 1998;126(2):185–90.CrossRefPubMedGoogle Scholar
    5. 15.
      Damji KF, et al. Selective laser trabeculoplasty versus argon laser trabeculoplasty: results from a 1-year randomised clinical trial. Br J Ophthalmol. 2006;90:1490–4.CrossRefPubMedPubMedCentralGoogle Scholar
    6. 16.
      Juzych MS, et al. Comparison of long-term outcomes of selective laser trabeculoplasty versus argon laser trabeculoplasty in open-angle glaucoma. Ophthalmology. 2004;111(10):1853–9.CrossRefPubMedGoogle Scholar
    7. 17.
      McIlraith I, et al. Selective laser trabeculoplasty as initial and adjunctive treatment for open-angle glaucoma. J Glaucoma. 2006;15:124–30.CrossRefPubMedGoogle Scholar
    8. 18.
      Moriarty AP, et al. Comparison of the anterior chamber inflammatory response to diode and argon laser trabeculoplasty using a laser flare meter. Ophthalmology. 1993;100:1263–7.CrossRefPubMedGoogle Scholar
    9. 19.
      Realini T. Selective laser trabeculoplasty for the management of open-angle glaucoma in St. Lucia. JAMA Ophthalmol. 2013;131(3):321–7.CrossRefPubMedGoogle Scholar
    10. 20.
      Rolim de Moura C, et al. Laser trabeculoplasty for open angle glau- coma. Cochrane Database Syst Rev. 2007;17(4):CD003919.Google Scholar
    11. 21.
      Shields MB, et al. Argon vs diode laser trabeculoplasty. Am J Ophthalmol. 1997;124:627–31.CrossRefPubMedGoogle Scholar
    12. 22.
      Stein JD, Challa P. Mechanisms of action and efficacy of argon laser trabeculoplasty and selective laser trabeculoplasty. Curr Opin Ophthalmol. 2007;18:140–5.CrossRefPubMedGoogle Scholar
    13. 23.
      The Glaucoma Laser Trial (GLT). 2. Results of the argon laser trabecu- loplasty versus topical medicines. The Glaucoma Laser Trial Research Group. Ophthalmology. 1990;97:1403–13.CrossRefGoogle Scholar
    14. 24.
      Wise JB, Witter SL. Argon laser therapy for open-angle glaucoma; a pilot study. Arch Ophthalmol. 1979;97:319–22.CrossRefPubMedGoogle Scholar


    1. 25.
      Iliev ME, Gerber S. Long-term outcome of transscleral diode laser cyclophotocoagulation in refractory glaucoma. Br J Ophthalmol. 2007;91(12):1631–5.CrossRefPubMedPubMedCentralGoogle Scholar
    2. 26.
      Kahook MY, Noecker RJ. Transscleral cyclophotocoagulation: techni- cal advice and pearls for clinical practice. Glaucoma Today. 2007:21–5.Google Scholar
    3. 27.
      Roberts S, et al. Efficacy of combined cataract extraction and endoscopic cyclophotocoagulation for the reduction of intraocular pressure and medication burden. Int J Ophthalmol. 2016;9(5):693–8.PubMedPubMedCentralGoogle Scholar
    4. 28.
      Youn J, et al. A clinical comparison of transscleral cyclophotocoagula- tion with neodymium:YAG and semiconductor diode lasers. Am J Ophthalmol. 1998;126:640–7.CrossRefPubMedGoogle Scholar

    Future Directions

    1. 29.
      Detry-Morel M, Muschart F, Pourjavan S. Micropulse diode laser (810 nm) versus argon laser trabeculoplasty in the treatment of open-angle glaucoma: comparative short term satey and efficacy profile. Bull Soc Belge Ophthalmol. 2008:21–8.Google Scholar
    2. 30.
      Dietlein TS, et al. Morphology of the trabecular meshwork three years after Erbium:YAG laser trabecular ablation. Ophthalmic Surg Lasers. 2001;32:483–5.PubMedGoogle Scholar
    3. 31.
      Feltgen N, et al. Endoscopically controlled erbium:YAG goniopuncture versus trabeculectomy: effect of intraocular pressure in combina- tion with cataract surgery. Graefes Arch Clin Exp Ophthalmol. 2003a;241:94–100.CrossRefPubMedGoogle Scholar
    4. 32.
      Feltgen N, et al. Combined endoscopic erbium:YAG goniopuncture and cataract surgery. J Cataract Refract Surg. 2003b;29:2155–62.CrossRefPubMedGoogle Scholar
    5. 33.
      Holz HA, Lim MC. Glaucoma lasers: a review of the newer tech- niques. Curr Opin Ophthalmol. 2005;16:89–93.CrossRefPubMedGoogle Scholar
    6. 34.
      Kahook MY, et al. One-site versus two-site endoscopic cyclophotoco- agulation. J Glaucoma. 2007;16(6):527–30.CrossRefPubMedGoogle Scholar
    7. 35.
      Lee J, et al. MicroPulse laser trabeculoplasty for the treatment of open-angle glaucoma. Medicine. 2015;94(49):1–6.CrossRefGoogle Scholar
    8. 36.
      Patel K, Martin E, Greenberg M, Patrianakos T, Johnstone M, Samples J, Giovingo M. Micropulse Cyclophotocoagulation: an update on a novel glaucoma treatment. In:Glaucoma Research and Clinical Advance, vol. 2; 2017.Google Scholar
    9. 37.
      Uram M. Endoscopic cyclophotocoagulation in glaucoma management. Curr Opin Ophthalmol. 1995;6(11):19–29.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Krishna B. Patel
    • 1
  • Michael C. Giovingo
    • 2
  • Ramez I. Haddadin
    • 3
  • Douglas J. Rhee
    • 4
  1. 1.Department of OphthalmologyJohn H. Stroger Hospital of Cook CountyChicagoUSA
  2. 2.Department of OphthalmologyStroger Hospital of Cook CountyChicagoUSA
  3. 3.Department of OphthalmologyStroger Hospital of Cook County, Northwestern UniversityChicagoUSA
  4. 4.Department of Ophthalmology and Visual ScienceUniversity Hospitals/Case Western Reserve University School of MedicineClevelandUSA

Personalised recommendations