In around 20% of uncomplicated cataract surgeries, even those done with the femtosecond laser, a secondary cataract may occur in the months of years following surgery. This problem can be easily solved by performing a creating a hole in the central part of the posterior capsule where the artificial lens has been implanted. Once this is done, cataract can no longer occur. Sometimes it is not possible cleaning the posterior capsule completely during surgery because of dense adhesions and therefore this laser is later necessary. Patients who have been implanted with multifocal lenses are very sensitive to the slightest presence of secondary cataract and often require this quick and safe laser treatment that takes only a couple of minutes to be carried out.
In some eyes, due to some congentical conformational issues, or in eyes with severe hypermetropia, the angle between the iris and the cornea may be extremely narrow, posing a risk of developing Acute Angle Closure Glaucoma (AACG). This is a very dangerous condition that could potentially blind the eye due to excessive internal pressure, if not treated immediately. In those eyes at risk of developing AACG we perform a tiny hole in the superior sector of the iris to prevent angle closure. This takes only a few minutes and it’s not painful. Sometimes the treatment needs to be completed in two sessions because of small blood clots that block the laser path and resolve spontaneously.
An alternative to glaucoma surgery or to taking frequent eye drops, can sometimes be performing this painless treatment called SLT. With SLT the iris tissue is massaged in such a way that the trabecular meshwork increases its filtering capacity, thereby reducing the pressure inside the eye. Some patients after this treatment may be able to stop using glaucoma drops altogether, while others may simply reduce the number and frequency of eye drops. Severe cases would still require a surgical approach.
Small dark spots of different shape and moving around the visual field are almost physiological and do not require any treatment, however massive spots centered in the visual fields and obstructing constantly the vision may be ameanable to treatment. We are amongst the very few centers in Italy offering laser treatment for vitreous floaters. Only 3 units of this Lumenis Selecta Trio laser have been installed in Italy. If you suffer from floaters, come and see us for a consultation. We will dilate the pupils and check size and location of these floaters and will let you know if you are a good candidate or not for laser treatment. Laser treatemnt can often be performed in the same session, but you will need sometone to drive you home afterwards and will see blurred for several hours. The treatment may require multiple sessions to be completed.
With the advent of anti VEGF drugs and intravitreal injections, argon laser treatment to the retina are done less and less, however they may still be required in certain cases of macular edema, severe proliferative diabetic retinopathy or vessels proliferation following central vein occlusion or other diseases causing leakage.
Small retinal breaks or holes (often found during routine eye examination), when they are not naturally sealed by a pigmentary reaction, need to be seald with the laser so that they don’t expand putting the eye at risk of developing a retinal detachment. Retinal detachments involving the macula (the central retina) require major eye surgery and carry a risk of irreversible damage to the vision or blindness.