Effect of a YAG Laser Iridotomy on Intraocular Pressure in Pigment Dispersion Syndrome

Gandolfi, Stefano; Vecchi, Marco

doi:10.1016/s0161-6420(96)30445-4

Cited by 47 publications

(52 citation statements)

References 8 publications

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“…Thus, in this context it is understandable, and not contradictory, that some authors who analysed the short-and intermediate-term effect of Nd:YAG laser iridotomy in eyes with PDS and PG reported only mild or no reduction of IOP [8,14], although they may have drawn inaccurate conclusions from their findings. Accordingly, it has been shown that Nd:YAG laser iridotomy reduces the incidence of IOP increase in eyes with PDS after 2 years [7], and in our study, both mean IOP and number of antiglaucomatous drugs were reduced 15±7 weeks following laser iridotomy. We ourselves were surprised by the good effect of Nd:YAG laser iridotomy on IOP.…”

Section: Discussionsupporting

confidence: 72%

Effect of neodymium:YAG laser iridotomy on number of aqueous melanin granules in primary pigment dispersion syndrome

Küchle

Nguyen

Mardin

et al. 2001

Graefe's Arch Clin Exp Ophthalmol

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Section: Discussionsupporting

confidence: 72%

Effect of neodymium:YAG laser iridotomy on number of aqueous melanin granules in primary pigment dispersion syndrome

Küchle

Nguyen

Mardin

et al. 2001

Graefe's Arch Clin Exp Ophthalmol

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“…As reported in the interim analysis, 7 the occurrence of an increase in IOP of 5 mm Hg or higher with respect to the baseline visit was adopted for the definition of a significant increase in IOP, and it was considered to be the "event" that the study was tailored to detect. This definition is consistent with that suggested by Epstein et al 10 for properly defining "pigmentary glaucoma suspects" (ie, patients with PDS who have an IOP of 22-23 mm Hg).…”

Section: Statistical Methods and Data Analysismentioning

confidence: 99%

“…Having 6 indepen-dent values for each daily phasing, we considered the IOP representative of that phasing of the average of the 2 highest values. 7 Calibration of the tonometer was performed routinely, according to the standardized operating procedure of the Clinical Trial Site of the European Vision Institute (http: //www.europeanvisioninstitute.org/news/evi-the-news-details /article/european-vision-institute-clinical-trials-sites-ofexcellence.html). Best-corrected visual acuity was a safety outcome measure.…”

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confidence: 99%

A 10-Year Follow-up to Determine the Effect of YAG Laser Iridotomy on the Natural History of Pigment Dispersion Syndrome

et al. 2014

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Prospective long-term analyses of the role of drug-induced mydriasis and laser peripheral iridotomy (LPI) are needed to identify and manage the eyes of patients with pigment dispersion syndrome (PDS) at risk for progressing to ocular hypertension.OBJECTIVE To assess the 10-year incidence of increased intraocular pressure (IOP) in the 2 eyes of patients with PDS, with 1 eye that underwent LPI and the other that did not. DESIGN, SETTING, AND PARTICIPANTSIn a randomized clinical trial in the glaucoma research unit at the University Hospital of Parma, Italy, 72 patients with PDS underwent phenylephrine testing. Of these 72 patients, 29 (58 eyes) tested positive for succeeding IOP elevation, and 43 (59 eyes) tested negative. For the 29 high-risk patients (all in both eyes), one eye was randomly assigned to LPI, and the fellow eye was left untreated. For the 43 low-risk patients, the affected eyes were left untreated.MAIN OUTCOMES AND MEASURES An IOP elevation of 5 mm Hg or higher vs baseline (daily phasing) was considered to be a significant increase (ie, an event). RESULTSIn the high-risk group, 3 of 21 eyes that underwent LPI (14.3%) and 13 of 21 untreated eyes (61.9%) showed an increase in IOP of 5 mm Hg or higher during the follow-up period; 4 of 35 low-risk eyes (11.4%) showed a similar increase. Event-free mean (SD) time was 7.99 (0.43) years for high-risk treated eyes, 3.89 (0.68) years for high-risk untreated eyes, and 7.16 (0.23) years for low-risk eyes. The log-rank test showed the following: P < .001 for treated high-risk eyes vs untreated high-risk eyes, P = .74 for treated high-risk eyes vs low-risk eyes, and P < .001 for untreated high-risk eyes vs low-risk eyes.CONCLUSIONS AND RELEVANCE At the end of the 10-year follow-up, (1) approximately one-third of the whole PDS patient population showed an IOP increase of 5 mm Hg or higher in at least 1 eye; (2) phenylephrine testing identified eyes at high risk for developing IOP elevation; and (3) LPI, when performed on high-risk eyes, reduced the rate of IOP elevation to the same level as the low-risk eyes.TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01053416

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“…8 Laser iridotomy results in a planar configuration of iris but may not completely prevent pigment liberation. 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.…”

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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Effect of a YAG Laser Iridotomy on Intraocular Pressure in Pigment Dispersion Syndrome

Cited by 47 publications

References 8 publications

Effect of neodymium:YAG laser iridotomy on number of aqueous melanin granules in primary pigment dispersion syndrome

Effect of neodymium:YAG laser iridotomy on number of aqueous melanin granules in primary pigment dispersion syndrome

A 10-Year Follow-up to Determine the Effect of YAG Laser Iridotomy on the Natural History of Pigment Dispersion Syndrome

Pigment dispersion syndrome

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