Argon Laser Trabeculoplasty in Pigmentary Glaucoma

Ritch, Robert; Liebmann, Jeffrey M.; Robin, Alan L.; Pollack, Irvin P.; Harrison, Raymond; Levene, Ralph Z.; Hagadus, James

doi:10.1016/s0161-6420(93)31555-1

Cited by 37 publications

(17 citation statements)

References 35 publications

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“…The reason for this success may be due to the greater energy absorption by the pigmented TM. In PG, ALT in young patients seems to be more effective than in older patients, unlike with POAG 142,144,149,150 . The location of pigment in the inner meshwork in young patients compared with the outer meshwork and around Schlemm's canal in older patients may explain this phenomenon 149 .…”

Section: Laser Trabeculoplastymentioning

confidence: 97%

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Pigment dispersion syndrome and pigmentary glaucoma – a major review

Niyadurupola

Broadway

2008

Clinical Exper Ophthalmology

176

167

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Pigment dispersion syndrome (PDS) is an interesting condition that can lead to secondary open angle glaucoma. Pigmentary glaucoma is primarily a disease of young people, myopes and men. PDS is characterized by the presence of Krukenberg spindles, iris trans-illumination defects, trabecular meshwork pigmentation and backward bowing of the iris. Posterior bowing of the iris causes rubbing of the pigmented iris epithelium against lens structures, liberation of pigment and trabecular meshwork changes that result in reduced aqueous outflow with the risk of glaucoma. Peripheral laser iridotomy can reverse backward bowing of the iris and may prevent progression of pigmentary glaucoma.

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Section: Laser Trabeculoplastymentioning

confidence: 97%

“…Argon laser trabeculoplasty (ALT) has been shown to be particularly effective in PG 117,140–149 . The reason for this success may be due to the greater energy absorption by the pigmented TM.…”

Section: Laser Trabeculoplastymentioning

confidence: 99%

Pigment dispersion syndrome and pigmentary glaucoma – a major review

Niyadurupola

Broadway

2008

Clinical Exper Ophthalmology

176

167

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“…9 Argon laser trabeculoplasty produces better results in younger patients because of location of pigment in the trabecular meshwork. 10 The purpose of presenting this case is to caution clinicians regarding the possible association of PDS in young myopes with Krukenberg's spindle. Many patients with PDS remain undetected, while those with glaucoma are misdiagnosed as having juvenile onset glaucoma or primary open angle glaucoma.…”

Section: Discussionmentioning

confidence: 99%

Pigment dispersion syndrome

Sandhya¹,

Krishna²,

Bhaskar³

2013

JCSR

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We report of the rare occurrence of pigment dispersion syndrome (PDS) with posterior subcapsular cataract in both eyes in a young male patient. The patient presented with complaints of progressive decrease in vision of one year duration. The patient also had high myopia with mild iridodonesis, phacodonesis and anterior insertion of zonules. Classical signs of PDS like Krukenberg's spindle on the posterior corneal surface were evident on slit lamp examination; transillumination defects in the iris could not be elicited by retroillumination as the iris was heavily pigmented. Gonioscopy revealed heavy and uniform pigmentation of trabecular meshwork. Evidence of a characteristic iris configuration on optical coherence tomography (OCT), namely, posterior bowing of iris in the mid periphery suggested the diagnosis of PDS. This case highlights the importance of OCT in identifying the iris configuration characteristically seen in PDS even in the absence of transillumination defects in the iris and reiterates the need to look for subtle signs like phacodonesis which are important when surgical intervention is planned.

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“…The success rate of argon laser trabeculoplasty in PG is greater in younger patients than in older ones and decreases with age [ 35 ]. Selective laser trabeculoplasty may result in marked rises of IOP secondary to pigment release.…”

Section: Treatmentmentioning

confidence: 99%