Dr. Sponsel performs various surgical procedures, including but not limited to; Non-penetrating Deep Sclerectomy, Implantation of Ahmed Tube Shunts with Tutoplast Grafts, Cataract Extractions with Intraocular Lens Implantation, Chorodial Drainage, and Anterior Vitrectomies.
He also performs many different lasers including Argon Laser Iridoplasties, Peripheral Iridectomies, Argon Rosette, and Peripheral Iridotomies.
This procedure uses Argon laser to shrink the peripheral iris, which pulls iris away from the trabecular meshwork and improves the out flow of fluid. Iridoplasty is similar to the other laser procedures. Topical anesthesia is used as well as a glaucoma medications (e.g. Brimonidine) to prevent post-laser pressure elevation. A contact lens is used to visualize the peripheral iris and its contraction with Argon laser energy. The laser treatment is usually well-tolerated by patients. Another glaucoma drop is placed
post-operatively and the pressure is checked 1hour post-operatively to rule out pressure spike.
A short course of topical steroids is prescribed. The complications are similar to those of the
other ocular laser procedures. Vision may be blurry for 1-3 days. It is recommended the patient limit activity the day of the laser. The patient can return to normal activities the next day.
Yag Laser Capsulotomy
During cataract surgery, your surgeon will remove the cioudy natural lens of your eye (cataract), replacing it with an intraocular lens implant.
When the cataract is removed, your surgeon makes every attempt to maintain the integrity ofthe capsule that contained the natural lens so the new lens can be placed within it. Normally your vision after cataract surgery should be very clear.
However, about 20 percent of patients with intact posterior capsules have haziness of the capsule, so vision is blurry.
This occurs because lens epithelial cells remaining after cataract surgery have grown on the capsule. In some cases, if the condition progresses significantly, your vision may be worse than it was before cataract surgery.
Fortunateiy, a YAG laser can treat posterior capsule opacity safely, effectively and painlessly. This procedure, known as YAG laser capsuiotomy, often can be performed in your doctor's office.
YAG laser capsulotomy involves just a few simple steps:
Usually the eye is dilated before the procedure, with dilating eye drops. A laser removes the hazy posterior capsule from your line of sight without making an incision or "touching" the eye.
Many ophthalmologists recommend anti-intiammatory eye drops following the procedure.
The procedure takes only a few minutes and is entirely painless; nor does discomfort occur post-operatively.
You must remain still during the procedure, however. Very uncooperative patients, such as children and mentally disabled people, may require sedation. Following a YAG laser capsulotomy, you may resume normal activities immediately. You may experience some floaters afterward. These will likely resolve within a few weeks.
Most people can expect their vision to improve within a day. As with any eye procedure, however, call your eye doctor immediately if vision worsens or fails to improve.
Laser Iridotomy for Glaucoma
Laser iridotomy uses a very focused beam of light to create a hole on the outer edge, or rim, of the iris, the colored part of the eye. This opening allows fluid (aqueous humor) to flow between the anterior chamber, the front part of the eye, and the area behind the iris, the posterior chamber. This opening may decrease pressure in the eye and usually prevents sudden buildup of pressure within the eye, which occurs during an episode of acute closed-angle glaucoma.
Some people feel a sensation of heat in the eye during laser surgeries. But there usually is no pain
after laser iridotomy.
What to Expect After Surgery
Laser iridotomy can be done without admitting the person to a hospital. The person will need to see his
or her doctor after laser surgery to monitor eye pressure. The person will also need to see the doctor
for a follow-up exam as recommended.
Why It Is Done
Laser iridotomy is used to:
Treat closed-angle glaucoma after the pressure in the affected eye has been reduced with
dedicine or when medicines fail.
Prevent closed-angle glaucoma in people who have narrow drainage angles and those people who have had closed-angle glaucoma in their other eye.
How Well It Works
Laser iridotomy can prevent further episodes of sudden (acute) closed-angle glaucoma.
Laser iridotomy can usually prevent slow-forming (subacute) closed-angle glaucoma in people who are
at risk for closed-angle glaucoma.
Possible Side Effects
Brief blurred vision (common)
Swelling of the clear covering (cornea) of the iris
Increased pressure in the eye for a day or two following the procedure
Argon Laser Trabeculosplasty
Argon Laser Trabeculoplasty is a common glaucoma laser surgery, which is performed in an office setting. It uses an Argon laser which delivers energy in blue-green wavelengths. A topical glaucoma eye drop is given just after the procedure to prevent a post-laser pressure elevation. The procedure itself usually takes less than 10 minutes. Patients rarely experience discomfort during the procedure. Once the eye is anesthetized with topical eye drop, a contact lens is placed on the surface of the cornea. The
gonioscopic contact lens allows visualization of the drainage angle. The laser spots are then delivered to the trabecular meshwork. Each area of the angle is treated only once to avoid scar formation in the angle. A short course of topical steroids is prescribed. The complications are similar to those of the other ocular laser procedures. Vision may be blurry for 1-3 days. It is recommended the patient limit activity the day of the laser. The patient can return to normal activities the next day.