For the first time in Bulgaria and Eastern Europe – intraoperative treatment of glaucoma with the new ELIOS laser

On December 16 and 17, 2025, at the Eye Clinic “PENTAGRAM,” the newest laser – ELIOS – was used for intraoperative surgical treatment of glaucoma. The procedure, which is performed for the first time in Bulgaria and Eastern Europe, was carried out by the team of Dr. Veselin Daskalov.

It is an excimer laser provided by the company Baush&Lomb, which delivers laser treatment in the blue spectrum with a wavelength of 308nm. This is cold light with very low power, around 1.2mJ, which does not cause a thermal effect.

The innovative approach was used for four patients with Primary Open-Angle Glaucoma and cataract. All four underwent a combined operation of Phacoemulsification with intraocular lens implantation and Laser Trabeculoplasty using the Elios laser. As early as the first postoperative day, intraocular pressure was normal in all operated patients.

“With this excimer laser, we perforate the trabecular apparatus of the eye (this is the zone through which the transport of intraocular fluid occurs and which is most affected in glaucoma), creating 10 microchannels in it. This improves the outflow of intraocular fluid through its physiological pathway,” explains Dr. Daskalov, who is one of the leading ophthalmologists in Bulgaria.

The greatest advantage of this procedure is that it can be used for a combined operation to remove cataracts, while simultaneously treating glaucoma.Unlike the methods used so far, the recovery period is extremely short . The effect for the patient occurs almost immediately, with their condition stabilizing completely within 2-4 weeks. After the procedure, glaucoma patients either reduce or completely stop using their eye drops.

“This laser has been used in Europe for several years, but now it will also be available in Bulgaria, giving us the opportunity for the most advanced treatment of this disease,” comments Dr. Veselin Daskalov.

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Glaucoma is a group of degenerative diseases united by one common feature – progressive and typical damage to the optic nerve and visual field. In this condition, the optic nerve is damaged due to high pressure. The reason for this is the excessive amount of intraocular fluid in the front part of the eye, whose gradual accumulation leads to increased intraocular pressure. Glaucoma is the second leading cause of blindness worldwide after cataracts and the first among older people. It is said about this disease that whatever it takes – it doesn’t return, that is, the vision loss caused by glaucoma is irreversible. Medicine can help stop the process from the moment it is detected, but it cannot restore lost vision.

Cataract, or “clouding of the eye,” is the clouding of the natural eye lens, which leads to blurred, unclear vision, problems with colors, and sensitivity to light, with the only treatment being surgical removal of the clouded lens and implantation of an artificial one. Although it is associated with aging (over 50-60 years old), it can occur earlier due to diabetes, trauma, inflammation, or steroids, and it most often develops slowly and painlessly.