Laser therapy in the treatment of glaucoma

Purpose
The paper is presenting the possibility of laser surgery in the treatment of glaucoma, new operations, and laser equipment. In the treatment of primary open angle glaucoma, argon laser was replaced by diode laser with continuous wave and in recent years by Nd: YAG Q switch, second harmonic 532nm. This laser allows ophthalmologists for selective fotoablation of cells with pigment in trabeculum without thermal effect. The introduction of fibers to transport energy let us increase accuracy and efficacy of laser therapy. Application of excimer lasers 308nm enables to perform trabeculectomy by internal (ELT) and deep sclerectomy. After NPDS we sometimes have to use Q switch Nd: YAG for goniopuncture, to prolong filtration function of trabeculum – Descemet membrane. In primary angle closure glaucoma the most often laser treatment is iridotomy and gonioplasty. Laser cyclodestructive procedures almost completely eliminated cyclodiathermy and cyclokriotherapy, which were performed so far. The main cyclophotocoagulative procedures are contact transscleral cyclophotocogulation, transpupillary cyclophotocoagulation and intraocular cyclophotocoagulation.

Conclusions
1. The introduction of lasers enables safer, quicker and more effective antiglaucoma operations. 2. New laser equipment increases efficacy of so far performed laser surgery. 3. Laser surgery allows for the resignation of patients hospitalization and thereby enables to decrease the cost of treatment, and to increase the comfort of patients.