INFORMED CONSENT FOR LASER TRABECULOPLASTY

You suffer of glaucoma or are at risk of having glaucoma. Your ophthalmologist proposes a laser treatment for your condition.

This document contains the information about the reasons, conditions, results, risks and limitations of the proposed medical act.

WHY LASER THERAPY?

Glaucoma can cause, chronologically, a progressive deterioration of the peripheral visual field followed by a decrease in central vision that may lead up to the permanent loss of vision.

Glaucoma is a major cause of blindness in the Western world. Among its many causes, the most common and most important is a too high a pressure in the eye.

Only your eye doctor is qualified to assess the harmfulness of the level of your eye pressure by taking into account all the data collected by an appropriate examination of your eyes: personal and familial background, fluctuations of your eye pressure, the quality of the retinal fibre layer, the status of your optic nerve, your visual field, the thickness of your cornea, the aqueous in- and outflow facilities in the anterior chamber etc.

Laser treatment is an appropriate means of lowering the pressure in the eye.

The goal of this treatment is to create a reaction scar at the level of the cells of the trabecular meshwork, which is a place of resistance to the outflow of the liquid produced by the eye. The expansion of the trabecular mesh leads to a greater ease of evacuation of the liquid and therefore a decrease in the pressure inside the eye.

THE LASER TREATMENT

The laser beam uses a light capable of carrying a large amount of energy that will be delivered in a specific location of the eye. It can create a scar that, by retracting, opens the spaces of the trabecular meshwork.

The session is performed on an outpatient basis. Anaesthesia of the eye is obtained by the instillation of anaesthetic drops. The patient sits in front of the laser engine. Laser impacts are applied through a lens placed on the eye. The whole procedure time does not exceed 20 minutes per session. It is painless.

The treatment is performed in 1 or 2 sessions spaced by several days to several weeks.

USUAL COURSE

In the vast majority of the cases, the treatment is well tolerated and you will leave immediately after treatment and resume your usual activities.

The eye care is reduced to nothingness or the instillation of drops in the manner that will be indicated by your ophthalmologist.

A decrease in pressure is achieved in most cases.

Control will be necessary at a date stated by your ophthalmologist.

COMPLICATIONS OF THE TREATMENT

The non serious complications are:

* Glare, due to the laser session itself, will be felt throughout the examination.

* Arterial hypotension may occur in susceptible individuals. It will quickly disappear when lying down.

* Irritation of the cornea (superficial keratitis): It is a rare hazard, occurring in less than 1% of the cases.
Promptly treated, it cures generally in 24 to 72 hours.

* A transient increase, during several hours to several days, of the intraocular pressure. It is a frequent hazard that is always treated preventively with hypotensive eye drops.

* Conjunctival bleeding due to the contact lens: rare, benign, disappears in few days.

These incidents are of no concern. If you are prone to arterial hypotension, please report it to your ophthalmologist in writing it at the bottom of this document.

A misplaced impact, reaching the middle of the centre of the retina is a severe complication of this treatment. This incident can permanently reduce detail vision. It is so rare that it is impossible to calculate its risk. It occurs in restless, undisciplined patients who do not control their eye movements and heir bodies. To avoid this, you are asked to keep the most calm and compliance during this examination.

LIMITATIONS OF THIS TREATMENT

This laser treatment is a complementary therapeutic tool available to your eye doctor to lower your eye pressure and prevent, as far as possible, the continuous development of glaucomatous damages.

Like all living tissues, the trabecular meshwork may react variably, immediately or along the months or years, to the impacts of laser. Thus, this treatment can not pretend preventing permanently subsequent increases of the intraocular pressure.

This laser treatment is often associated with a medical treatment to pursue the aim of lowering eye pressure. In some cases, glaucoma may continue somehow to develop, especially if other factors, particularly circulatory disturbances, are involved.

PRECAUTIONS TO BE TAKEN

During pregnancy, no complications due to eye laser treatment have been reported to the mother neither to the child to be born.

YOU SHOULD CONTACT YOUR OPHTHALMOLOGIST IMMEDIATELY IN CASE OF

• Pain, severe sensitivity to light, redness, tearing, secretions, swelling of the eyes or eyelids
• Sharp decrease of the vision.