Iridotomy vs. Iridectomy — What's the Difference?

Iridotomy, specifically laser peripheral iridotomy (LPI), is a minimally invasive procedure used primarily to treat narrow-angle glaucoma. This procedure uses a laser to create a small hole in the iris, which helps fluid (aqueous humor) to flow better in the eye and reduces intraocular pressure. On the other hand, an iridectomy involves the surgical removal of a part of the iris and is used in cases where laser iridotomy may not be sufficient, or when the iris itself is causing obstruction or has suffered damage.

While iridotomy is generally performed as an outpatient procedure with minimal recovery time, iridectomy, being more invasive, may require more extensive post-operative care. Iridotomy is usually quick, involves less risk of infection, and patients often return to their normal activities within a day, whereas iridectomy might require stitches and a longer healing period.

In terms of indications, iridotomy is recommended for patients with narrow or closed angles in their eyes, which are at risk of developing acute angle-closure glaucoma. Whereas, iridectomy is often reserved for patients who cannot undergo laser procedures or in cases where the iris is physically blocking the drainage of aqueous humor, such as in iris bombe.

Iridotomy uses advanced laser equipment that allows precise control with minimal discomfort. Iridectomy, however, may involve either traditional surgical tools or lasers, depending on the specific circumstances and needs of the patient.

The choice between iridotomy and iridectomy depends on the severity of the condition, the specific anatomical issues of the patient’s eye, and how urgently the intraocular pressure needs to be reduced. Both procedures aim to prevent the progression of glaucoma by improving the outflow of aqueous humor.