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Nd: YAG Lasers and Eye Therapies

It is a photodestructive laser that is used to treat secondary cataracts and glaucoma. The procedure is ambulatory and is generally performed under local anesthesia.

WHAT IS THE Nd: YAG LASER?

It is a laser, called a “solid-state”, which is used to cure some eye diseases. Its peculiarity consists in destroying the targeted tissue: this characteristic is called “photodestructive laser”.

WHEN IS IT USED?

The Nd: YAG laser is used as an outpatient treatment:

  • The “secondary cataract”: a frequent consequence of cataract surgery, characterized by the progressive opacification of the capsule that contains an artificial intraocular lens that replaces the natural lens in our eye. The appearance of this fogging leads to a progressive reduction in vision and can occur even a few months after surgery. Using the Nd: YAG Laser the posterior opaque capsule is pierced, creating a passageway for the light. In this way, visual fogging can be eliminated. This is possible because, when working with cataracts the outer shell of the natural crystalline is maintained, a sort of thin membrane inside which the artificial lens is then inserted.
  • The glaucoma narrow-angle: the amplitude reduction of the angle iridoid corneal causes an increase in intraocular pressure. Through the Nd: YAG Laser, one or more holes are made on the iris that allows facilitating the outflow of the aqueous humor and therefore, reduce the intraocular pressure.
  • In the procedures of primary open-angle glaucoma, the Nd: YAG laser can be used to treat an eye structure, called trabeculate, which serves to drain the aqueous humor (SLT: Selective Laser Trabeculoplasty). This treatment is recommended only in the methods of glaucoma refractory to medical therapy which no longer responds to the classic therapy with eye drops. It consists of striking the trabecular meshwork with different laser spots so that the liquid contained in the bulb can flow more easily and the pressure inside the eye is reduced.

HOW IS THE TREATMENT PERFORMED?

The intervention is ambulatory. Anesthetic drops are instilled into the eye to prevent pain from undergoing treatment (subject to the signing of informed consent). Subsequently, the ophthalmologist uses a lens to better observe the area of operation and therefore, uses a luminous aim to correctly direct the laser on the structures to be drilled. Slight discomfort in the eye may occur during treatment. In the end, an anti-inflammatory eye drop is generally instilled. Further medical and eye checks are required in the days following the operation.

WHAT PRECAUTIONS SHOULD I TAKE BEFORE AND AFTER TREATMENT?

On the same day of the treatment and in the following days (varies according to the illness), it is important not to undergo strenuous tasks. The therapies that are prescribed after the operation are based on anti-inflammatory and eye drops (to be instilled for seven to ten days after the laser, reducing the eye pressure).

WHAT ARE THE SIDE EFFECTS?

The most frequent but minor side effect is the redness of the eye caused by the lens that the ophthalmologist has used during treatment (making it come into contact with the ocular surface). However, this problem can resolve within a few days.
During the treatment, minor bleeding may occur but this generally resolves within a few minutes.
A possible complication is also the appearance of peripheral retinal breaks following the laser treatment for (secondary) opacification of the crystalline lens.
Finally, the formation of macular edema is rare which usually resolves spontaneously.

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