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What Is Iridoplasty (Gonioplasty)?

Iridoplasty, sometimes called gonioplasty, is a laser procedure that places small burns on the peripheral iris. The burns cause the iris tissue to contract and pull away from the drainage angle. By opening the angle, iridoplasty can lower eye pressure or reduce the chance of angle closure in selected cases. Doctors most often use it for plateau iris or for angle closure that persists after a laser iridotomy. The procedure is typically done in a clinic and takes only a few minutes per eye.

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What Is Iridoplasty (Gonioplasty)?

Iridoplasty, sometimes called gonioplasty, is a laser procedure that places small burns on the peripheral iris. The burns cause the iris tissue to contract and pull away from the drainage angle. By opening the angle, iridoplasty can lower eye pressure or reduce the chance of angle closure in selected cases. Doctors most often use it for plateau iris or for angle closure that persists after a laser iridotomy. The procedure is typically done in a clinic and takes only a few minutes per eye.

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How Does Iridoplasty Work?

During iridoplasty, a clinician applies a contact lens to the eye and uses laser spots on the far edge of the iris. The spots create a tightening effect that pulls the iris away from the trabecular meshwork area. This changes the iris contour and can widen the angle so fluid drains more freely. The approach differs from a laser iridotomy, which creates a tiny hole in the iris to relieve pupillary block. Iridoplasty targets the shape of the iris rather than creating a passage through it.

When Do Eye Doctors Use Iridoplasty?

Iridoplasty is not used for every narrow-angle situation. The decision depends on what is driving the angle closure and what the angle looks like on gonioscopy.

  • Plateau iris configuration or plateau iris syndrome when the angle stays narrow after laser iridotomy.
  • Acute angle closure when medication lowers pressure but the angle still stays crowded.
  • Chronic narrow angles with intermittent closure symptoms in select cases.
  • Angle closure triggered by pupil dilation in a person with a crowded angle.
  • Persistent appositional angle closure without extensive scar tissue in the angle.

What Should A Patient Expect During Iridoplasty?

Before the procedure, numbing drops and a pressure-lowering drop are commonly used. A bright light and mild pressure from the contact lens can feel strange, yet the laser spots are brief. Some people feel a quick sting or warmth with a few spots. Afterward, the eye can look red and feel irritated for a day or two, and anti-inflammatory drops are often prescribed. Eye pressure is checked shortly after treatment since a short-lived pressure rise can occur.

What Are The Risks And Side Effects Of Iridoplasty?

Common short-term effects include light sensitivity, eye redness, and mild pain. A temporary eye pressure spike can happen, which is why pressure checks follow soon after the procedure. Some people develop inflammation that needs drop treatment. Rarely, the angle does not open enough, and further glaucoma treatment is still needed. A clinician gives specific aftercare steps and schedules follow-up visits based on eye pressure and angle findings.

Frequently Asked Questions About Iridoplasty (Gonioplasty)

Is Iridoplasty The Same As Laser Iridotomy?

No. Laser iridotomy creates a small opening through the iris to relieve pupillary block. Iridoplasty places laser spots on the peripheral iris to change its shape and pull it away from the angle. Both procedures can be used in angle-closure care, based on the mechanism seen on exam. An eye doctor can explain which procedure fits a given anatomy.

How Long Do Iridoplasty Results Last?

Results can last for years in some cases, yet the angle can narrow again over time. Long-term control depends on the underlying angle anatomy and whether scar tissue forms. Regular gonioscopy and pressure checks show whether the angle stays open. Repeat treatment or other glaucoma care is sometimes needed.

Does Iridoplasty Hurt?

Most people tolerate iridoplasty with numbing drops. Some feel brief stinging or warmth when the laser spots are placed. Mild irritation and light sensitivity can last for a short period after treatment. Persistent pain or marked vision change should prompt a call to the clinic.

Can Iridoplasty Replace Glaucoma Drops?

Iridoplasty can lower pressure or reduce angle closure risk, yet drops are still needed for many patients. The pressure goal and optic nerve status guide whether drops continue. Some patients need other procedures, such as lens surgery or filtration surgery, even after iridoplasty. Follow-up visits show how well pressure stays controlled.

References

1. Argon Laser Peripheral Iridoplasty. EyeWiki (American Academy of Ophthalmology). https://eyewiki.org/Argon_Laser_Peripheral_Iridoplasty. Accessed January 29, 2026.

2. Plateau Iris Syndrome. StatPearls (NCBI Bookshelf). https://www.ncbi.nlm.nih.gov/books/NBK470327/. Accessed January 29, 2026.

3. Angle-Closure Glaucoma. American Academy of Ophthalmology. https://www.aao.org/eye-health/diseases/angle-closure-glaucoma. Accessed January 29, 2026.

4. Laser Peripheral Iridoplasty in Acute Angle Closure. Glaucoma Today. https://glaucomatoday.com/articles/2011-mar/laser-peripheral-iridoplasty-in-acute-angle-closure. Accessed January 29, 2026.

5. Argon laser peripheral iridoplasty for angle closure. PubMed. https://pubmed.ncbi.nlm.nih.gov/2130911/. Accessed January 29, 2026.