YAG Peripheral Iridotomy (YAG PI)

What Is YAG Peripheral Iridotomy (YAG PI)?

YAG Peripheral Iridotomy (YAG PI) is a type of glaucoma laser treatment performed to prevent or treat angle-closure glaucoma. It uses a highly focused YAG laser to make a microscopic hole near the edge of the iris, the coloured part of the eye. This small passage allows trapped aqueous fluid to move from the back chamber to the front of the eye, equalising pressure and keeping the drainage angle open.

The YAG laser peripheral iridotomy procedure is non-invasive, takes only a few minutes, and is typically painless. It is an effective way to prevent vision-threatening complications without the need for traditional surgery.

Why Is YAG PI Laser Treatment Needed?

YAG PI laser treatment is recommended when a patient is at risk of developing or already has angle-closure glaucoma. In this condition, the iris blocks the fluid drainage system, causing a sudden rise in pressure. The YAG PI eye surgery prevents such blockages by providing an alternate pathway for fluid flow.

Key reasons for performing YAG laser peripheral iridotomy include:

• Prevention of angle-closure attacks: Reduces the risk of sudden and painful increases in eye pressure.

• Reduction of intraocular pressure: Improves fluid outflow, keeping pressure within a healthy range.

• Protection of the optic nerve: Prevents permanent nerve damage that leads to vision loss.

• Preventive care for high-risk patients: Recommended for individuals with narrow angles detected during an eye exam or those with a family history of glaucoma.

How Does YAG PI Eye Surgery Work?

YAG PI eye surgery is a precise and controlled laser trabeculoplasty procedure that targets the iris. Here’s how it works:

• Anaesthetic drops are applied to numb the eye and ensure comfort.

• A special contact lens is placed on the eye to focus the YAG laser.

• The laser creates a tiny hole in the peripheral iris, usually in the upper part, where it’s less visible.

• This new channel allows aqueous fluid to move freely between chambers, relieving pressure and preventing further blockages.

The YAG PI laser treatment restores the eye’s natural fluid balance, reducing the risk of optic nerve damage and glaucoma progression.

What to Expect During YAG Laser Peripheral Iridotomy

Pre-Procedure Preparation

Before the YAG PI laser procedure, your ophthalmologist will perform a comprehensive eye examination. This will include intraocular pressure measurement and gonioscopy (a test to view the eye’s drainage angle).

You may be prescribed eye drops to constrict the pupil and lower pressure before treatment. Proper YAG PI laser preparation ensures accuracy and safety during the procedure.

During the Procedure

The YAG laser peripheral iridotomy procedure is typically completed within 5-10 minutes. The patient remains seated at a slit lamp microscope during a standard eye examination. 

After applying numbing drops, the ophthalmologist uses the laser to create the microscopic opening. Most patients describe the process as painless, with only slight pressure or flashing light sensations.

Recovery and Aftercare Following YAG PI Laser Treatment

Post-Treatment Instructions

After the procedure, patients may experience mild irritation, redness, or light sensitivity. Anti-inflammatory eye drops are prescribed to reduce swelling and aid healing. 

These are part of standard YAG PI aftercare and help prevent temporary pressure fluctuations. Vision usually stabilises within a few hours.

Returning to Normal Activities

The YAG PI recovery time is short. Most individuals can resume their regular routines, including reading and light work, within a day. 

However, it is important to avoid rubbing the eyes or engaging in strenuous activities immediately after treatment. Regular follow-up visits are essential to ensure the iridotomy remains open and effective.

Risks and Complications of YAG PI Laser

While the YAG PI laser is very safe, some mild side effects can occur. These include temporary increases in eye pressure, redness, glare, halos, or mild discomfort. In rare cases, the opening may close and require a repeat treatment.

Common YAG PI laser risks include:

• Temporary pressure spike shortly after the procedure

• Mild inflammation or redness

• Light sensitivity or glare

• Closure of the iridotomy hole, requiring another laser session

Serious complications such as bleeding or permanent vision problems are extremely rare

 Benefits of YAG PI Over Other Treatments

The benefits of YAG PI make it one of the most effective and widely recommended preventive glaucoma treatments.

• Quick and outpatient-based: The procedure takes less than 10 minutes and requires no hospital stay.

• Minimally invasive: No incisions or stitches are involved.

• Prevents acute angle-closure glaucoma: Reduces the risk of sudden increases in eye pressure.

• Reduces dependency on medications or surgery: Many patients experience long-term control without additional interventions.

When comparing YAG PI vs surgical iridectomy, the laser version is preferred for its precision, comfort, and faster recovery.

Who Should Consider YAG PI Eye Surgery?

Candidates for YAG PI eye surgery include individuals at risk of developing angle-closure glaucoma or those already experiencing early signs. It is particularly beneficial for:

• Patients with narrow angles identified during routine eye exams

• Those with a history of angle-closure symptoms, such as pain, blurred vision, or seeing halos

• Individuals with a family history of glaucoma

• High-risk eyes, including hyperopic (farsighted) patients and those with thick lenses

Your ophthalmologist will determine suitability after a detailed examination and discussion of treatment options.

Conclusion: Is YAG Peripheral Iridotomy the Right Choice?

YAG Peripheral Iridotomy (YAG PI) is a safe, efficient, and effective laser treatment to prevent glaucoma-related vision loss. It improves fluid circulation, lowers intraocular pressure, and protects the optic nerve from irreversible damage. 

For patients at risk of angle-closure glaucoma, YAG PI laser treatment offers an excellent preventive solution that is quick, painless, and minimally invasive. Consulting an experienced ophthalmologist can help determine whether YAG PI eye surgery is the best option for your eye health.