ABSTRACT
This chapter discusses the use of the laser in the treatment of glaucoma. The application of lasers with shorter wavelengths and better spatial confinement of applied energy led to the reproducible creation of laser iridectomies. Continuous-wave lasers include argon, krypton, frequency doubled Nd:yttrium aluminium garnet (YAG), and diode. The Nd:YAG laser is the laser of choice for the creation of laser iridectomies in most situations. The laser energy is spatially confined by cells containing pigment creating fatal injury on a microscopic scale. The delivery of laser energy during endoscopic cyclophotocoagulation is markedly different from transscleral delivery techniques. Continuous-wave lasers require a longer exposure time to deliver sufficient energy to cause cyclophotocoagulation; the effects are more coagulative in nature. The use of a contact fiberoptic probe also creates a focal relative desiccation of sclera, increasing scleral transmission of laser light.
