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What Is Laser Iridoplasty?

Laser iridoplasty is a procedure that applies laser spots to the peripheral iris to contract the tissue and pull it away from the eye's drainage angle. This can widen the anterior chamber angle and help aqueous humor drain more easily, lowering intraocular pressure (IOP). It is most often performed as argon laser peripheral iridoplasty (ALPI). Laser iridoplasty is commonly used for certain angle-closure situations, especially when a laser peripheral iridotomy is not enough.

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What Is Laser Iridoplasty?

Laser iridoplasty is a procedure that applies laser spots to the peripheral iris to contract the tissue and pull it away from the eye's drainage angle. This can widen the anterior chamber angle and help aqueous humor drain more easily, lowering intraocular pressure (IOP). It is most often performed as argon laser peripheral iridoplasty (ALPI). Laser iridoplasty is commonly used for certain angle-closure situations, especially when a laser peripheral iridotomy is not enough.

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When Laser Iridoplasty Is Used

Iridoplasty is used for appositional angle closure where the peripheral iris is crowding the drainage structures. It can be helpful in acute primary angle closure to rapidly open the angle after initial medical stabilization. It is also used in plateau iris configuration when a patent laser peripheral iridotomy does not fully open the angle.

  • Acute primary angle closure with persistent angle crowding
  • Plateau iris syndrome after a patent iridotomy
  • Angle closure related to iris cysts or very small eyes in selected cases

How It Works

The laser creates small contraction burns in the far peripheral iris. As the spots contract, the iris tissue tightens and is pulled away from the trabecular meshwork, which can open the angle. The effect is mechanical and does not replace evaluation for other angle-closure mechanisms. Doctors confirm angle anatomy with gonioscopy before and after treatment.

What to Expect and Aftercare

The procedure is typically done in clinic with numbing drops and a special contact lens. You may see bright lights and feel mild pressure or brief discomfort. Anti-inflammatory drops are often prescribed afterward, and eye pressure may be checked shortly after treatment. Follow-up visits confirm that the angle is more open and that IOP is stable.

  1. Numbing drops and a lens are placed on the eye
  2. Laser spots are applied around the peripheral iris
  3. IOP and inflammation are monitored at follow-up

Risks and Limitations

Short-term inflammation and a temporary IOP rise can occur, which is why monitoring is important. Some patients experience transient glare, mild pain, or light sensitivity. Iridoplasty may not be effective if angle closure is driven mainly by lens-related crowding or extensive synechiae. Additional treatments such as lens extraction, medications, or glaucoma surgery may still be needed.

  • Inflammation or transient IOP spike
  • Corneal irritation or temporary blur
  • Incomplete response if structural angle closure is advanced

FAQs on Laser Iridoplasty

Is laser iridoplasty the same as laser peripheral iridotomy?

No. Laser peripheral iridotomy creates a small opening in the iris to relieve pupillary block. Iridoplasty places contraction burns on the peripheral iris to physically pull it away from the drainage angle. They are used for different mechanisms and are sometimes used together.

Is the effect of iridoplasty permanent?

It can be long-lasting, but the angle can narrow again over time depending on the underlying anatomy and lens changes with age. Ongoing monitoring is still needed. Your doctor may recommend additional treatment if narrowing returns.

Can laser iridoplasty be repeated?

In selected cases, yes. Repeat treatment depends on the iris response, the cause of angle closure, and the overall plan for pressure control. Your ophthalmologist will weigh benefit versus inflammation risk.

What symptoms after iridoplasty need urgent care?

Seek urgent evaluation for severe pain, marked redness, sudden vision loss, nausea with eye pain, or rapidly worsening light sensitivity. Mild irritation is common early, but symptoms should improve with time and prescribed drops.

References

Iridoplasty. EyeWiki. https://eyewiki.org/Iridoplasty. Date Accessed February 9, 2026.

Plateau Iris Syndrome: A Review. PubMed (National Library of Medicine). https://pubmed.ncbi.nlm.nih.gov/37918992/. Date Accessed February 9, 2026.

Diagnosis and Management of Plateau Iris. American Academy of Ophthalmology EyeNet. https://www.aao.org/eyenet/article/diagnosis-and-management-of-plateau-iris.Date Accessed February 9, 2026.

Glaucoma. StatPearls (NCBI Bookshelf, National Institutes of Health). https://www.ncbi.nlm.nih.gov/books/NBK538217/. Date Accessed February 9, 2026.

Laser Peripheral Iridoplasty: Procedures and Pitfalls. Expert Review of Ophthalmology. https://www.tandfonline.com/doi/full/10.1080/17469899.2024.2305743. Date Accessed February 9, 2026.