☆ Is there an order of priority between traditional surgery and laser treatment? Laser treatment is simpler than traditional surgery, takes less time to treat, causes less damage, and can be done on an outpatient basis. Many patients can reduce or even eliminate the need for further eye drops after the review. Huang Yingxiang of the Beijing Friendship Hospital Ophthalmology Department needs to add IOP-lowering drops when the disease progresses and laser alone cannot achieve control of the disease. When the condition deteriorates further and the IOP is not well controlled, traditional surgery is considered. However, some patients have already missed the time when they can rely on laser treatment to control their glaucoma condition at the time of consultation, and then they can only rely on traditional surgery. ☆ What types of glaucoma is laser treatment suitable for? Not all patients with glaucoma are suitable for laser treatment. For primary narrow-angle glaucoma, one eye with glaucoma attacks and the other eye is recommended to have iris laser treatment in time to prevent glaucoma attacks. For eyes with few episodes prior to the visit and no complete adhesions in the atrial angle, prompt iris laser treatment is recommended. When the IOP is not satisfactorily controlled during the primary glaucoma attack, peripheral atrial angle shaping may be considered to assist in controlling the IOP. For primary open-angle glaucoma, selective laser trabeculoplasty (SLT) is also a good option. ☆ What do the different types of laser treatments do? Can I get it done without recurrence? As mentioned above, different types of lasers work for different glaucomas and different periods of glaucoma, and the exact type of laser used depends on the patient’s condition. In short, lasers can help open up the pathway for atrial flow to facilitate the reduction of intraocular pressure and prevent glaucoma from getting worse. The length of time that the laser’s effect can be maintained varies depending on the patient’s condition at the time of the visit. In some patients with early glaucoma who have only a narrow atrial angle, laser treatment can prevent glaucoma attacks from recurring. ☆ Can the IOP remain normal for a long time after laser treatment? Can it slow down the vision loss? The IOP control after laser treatment is related to the patient’s condition. The earlier the patient is, the longer the IOP remains normal after laser treatment, the better the IOP control, the less the possibility of visual field damage, and the slower the vision loss. It is important to emphasize here that the damage of glaucoma first shows the damage of the visual field, i.e. the size of the range seen. It is only in the advanced stage that the loss of vision is manifested. ☆ Can I have laser treatment in both eyes at the same time? In general, we recommend that both eyes be treated separately to avoid an increase in intraocular pressure after laser treatment. It is possible to have laser treatment in both eyes at the same time, taking into account the patient’s condition and monitoring the IOP. ☆ Do I need laser treatment in one eye when I have an acute attack in the other eye? Laser treatment is recommended for one eye with an acute attack and the other eye. ☆ What are the circumstances under which the treatment may fail? Is there a risk of blindness? When the iris is very thick, it is possible that one laser treatment may not achieve the treatment goal, or the laser hole may close again, or one laser hole may not be enough to achieve the treatment goal, and we can treat the eye with laser again. There is a risk of blindness if the IOP is not satisfactorily controlled. Laser treatment itself does not cause blindness, but close monitoring of IOP after laser treatment is the key to avoiding blindness. ☆ What should I do if my IOP does not drop significantly after laser treatment? If the IOP does not decrease significantly after laser treatment, you should look for the cause of the unsatisfactory decrease in IOP and treat the cause. ☆ Do I still need long-term medication to lower IOP after laser treatment? How do I use it? It depends on the condition. ☆ What should I do if my IOP rises again some time after laser treatment? We will look for the cause of the IOP rise again and treat the cause. Additional medication or surgery may be considered. ☆ After laser treatment – What are the causes of increased eye pressure, swelling and pain, eye congestion, constant tearing, excess light in the eyes, loss of vision, and dry eyes? What should I do? After laser treatment – elevated eye pressure, swelling and pain, blood in the eyes —– See a doctor immediately and add medication to control eye pressure. –Continuous tearing, excess light in the eye, loss of vision, dry eyes —- Control the inflammatory response after laser treatment and add dry eye eye drops. It usually improves quickly. ☆ What is wrong with the pupil shrinking very small after laser treatment with regular medication? How do I deal with it? What should I do if I find that my pupils have become larger after surgery? The pupil will become smaller when pupil reduction medication is often used before laser treatment. After laser treatment, the pupil will return to normal on its own when the pupil reduction medication is stopped. The pupil is usually not larger than normal after surgery. High intraocular pressure can cause the pupil to become larger, and some glaucoma attacks that are not controlled in time can result in a larger pupil that never recovers. Therefore, it is important to seek medical attention in a timely manner.