Outcome of laser peripheral iridotomy in the spectrum of primary angle closure disease

Abstract

To study the effectiveness of Nd: YAG laser peripheral iridotomy (LPI) in whole spectrum of primary angle closure disease including primary angle closure suspect (PACS), primary angle closure (PAC) and primary angle closure glaucoma (PACG). Materials and Methods: It's a retrospective analysis of 171 eyes (87 patients) of primary angle closure disease who have undergone laser peripheral iridotomy (LPI) after proper prelaser evaluation. Patients with prior LPI, glaucoma surgery and secondary glaucoma were excluded. Results were analysed for IOP control, progression of disease and need of antiglaucoma medicine or surgery following LPI. Results: Out of 171 eyes of angle closure diseases, PACS was observed in 23 eyes, PAC in 51 eyes and PACG in 97 eyes. Overall progression was 23.97% (41 amongst 171 eyes) and none of the eyes with PACS shown progression. In PAC group, 5 eyes (9.8%) progressed to PACG and were managed on one antiglaucoma drug. In PACG group of 97 eyes, 36 eyes (37.11%) progressed and managed surgically while 61 (62.89%) eyes did not show any progression. Out of 61 non progressed PACG eyes, IOP was controlled without medication in 14 eyes (29.2%), with one anti glaucoma drug in 17 eyes (27.8%), and with 2 or more drugs in 30 eyes (49.18%). Conclusion: LPI is a very good treating modality, especially in PAC & PACS cases, but in PACG with medical treatment, it is a good tool. Majority of the patients included in the study did not show any disease progression and remained stable following LPI.

Comparison of Nd: YAG Laser Iridotomy Alone Versus Sequential Argon-Nd: YAG Laser Iridotomy in Patients with Primary Angle Closure Spectrum

“…The European Glaucoma Society stages the patients of primary angle closure spectrum into primary angleclosure suspect (PACS), primary angle closure (PAC), and primary angle closure glaucoma (PACG), according to course of disease progression. 5,6 Laser peripheral iridotomy (LPI) is indicated for the treatment of all the patients having primary angle closure spectrum disease with pupillary block. [7][8][9] It is easier and less invasive than surgical peripheral iridectomy.…”