Comparison of New Visual Disturbances after Superior versus Nasal/Temporal Laser Peripheral Iridotomy

Srinivasan, Kavitha; Zebardast, Nazlee; Palaniswamy, Krishnamurthy; Kader, Mohideen Abdul; Raman, Ganesh V; Rajendrababu, Sharmila; Venkatesh, Rengaraj; Ramulu, Pradeep Y.

doi:10.1016/j.ophtha.2017.09.015

Cited by 34 publications

(24 citation statements)

References 19 publications

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“…8 Conversely, a study by Srinivasan and colleagues randomized both eyes of patients to either superior or temporal/nasal LPI locations and did not find a significant difference in reported new-onset dysphotopsias. 9 Our institutional preference is to place them in the temporal location; however, given the lack of clear evidence, people who implement this curriculum may choose to recommend either location.…”

Section: Discussionmentioning

confidence: 99%

Laser Peripheral Iridotomy Curriculum: Lecture and Simulation Practical

2020

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Introduction: Approximately 20 million people worldwide are affected by primary angle closure glaucoma, which is often treated with a laser peripheral iridotomy (LPI). In the United States, at least 60,000 to 80,000 LPIs are performed annually. However, complications can arise from improperly performed LPIs. While the Accreditation Council for Graduate Medical Education requires that all ophthalmology residents perform at least four primary LPIs prior to graduating, formal training is often lacking. In an effort to standardize LPI teaching, an LPI lecture curriculum and skills practice session were introduced. Methods: A lecture and wet-lab curriculum was developed at the University of Washington to formally teach first-year ophthalmology residents the indications and techniques for LPI. Pre-and postcurriculum knowledge was tested, and LPI performance was assessed by comparing pre-and postcurriculum total number of shots and time needed to successfully complete an LPI on a commercially available model eye. Results: The course was highly rated by 10 residents (all PGY 2), with an increase in pre-versus posttest scores, an improvement in LPI performance metrics, and an increase in preversus postcurriculum scores for the three survey questions regarding curriculum objectives. Discussion: This course improved learner knowledge and confidence in performing LPI. Test scores improved following the course, as did self-assessed confidence levels of the residents. Residents made a number of positive comments about the course. We plan to continue holding this training session every year at our institution.

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Section: Discussionmentioning

confidence: 99%

Laser Peripheral Iridotomy Curriculum: Lecture and Simulation Practical

2020

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“…This finding influenced many ophthalmic surgeons to switch from superior to temporal placement. More recently, however, a larger study by Srinivasan et al in India (n=559) 17 showed that dysphotopsia incidence was similar regardless of iridotomy location (8.4% for superior versus 9.5% for temporal; p=0.7). This finding may persuade ophthalmic surgeons to revert back to using superior iridotomy for glaucoma treatment, as was their previous practice.…”

Section: Q: How Has Our Understanding Of Glaucoma Advanced In 2017?mentioning

confidence: 93%

Recent Developments in Glaucoma

Lim¹

2017

European Ophthalmic Review

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Glaucoma continues to exert a heavy disability and economic burden and is the most frequent cause of irreversible blindness worldwide. In 2015, 57.5 million people globally were affected by open-angle glaucoma and this is predicted to increase to 65.5 million by 2020. The prevalence of glaucoma increases with age in all populations and generally more men and people of Hispanic and Black race are affected. Effective treatments to lower and maintain intraocular pressure (IOP) and convenient means of continuously monitoring it remain substantial unmet medical needs. In this expert interview Kin Sheng Lim from Guy’s and St Thomas’ Hospitals, London, UK, discusses the new developments to improve this situation and are therefore of great interest to ophthalmologists and to the wider population who are at risk from glaucoma.

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“…A new randomized clinical trial (RCT) that compared visual disturbances following superior versus nasal/temporal laser peripheral iridotomy (LPI) did not find a statistically significant difference between locations . The authors of the study concluded that considerations other than location should be given greater weight when performing an iridotomy.…”

mentioning

confidence: 99%

“…The following data from the current RCT were incorporated in the analysis: 24 (8.4%) of the 285 patients undergoing a superior iridotomy and 26 (9.4%) of the 274 patients undergoing a nasal/temporal location developed any new dysphotopsia …”

mentioning

confidence: 99%