title: Dilated, miotic-resistant pupil and laser iridotomy in primary angle-closure glaucoma.
abstract: We analyzed 22 eyes with primary angle-closure glaucoma that underwent initial laser iridotomy to determine which factors could lead to subsequent trabeculectomy. Twenty-two eyes were divided into two groups: (1) the eyes in which intraocular pressure (IOP) could be controlled by iridotomy and/or topical medication (iridotomy success group, 15 eyes) and (2) the eyes that underwent trabeculectomy to control IOP in spite of a patent opening (iridotomy failure group, 7 eyes). The clinical variables between the two groups were analyzed. Age, sex, visual field defect, presenting IOP and cup/disk ratio were not significantly different between the iridotomy success and failure groups. However, presence of peripheral anterior synechiae (PAS) greater than 50% was found more frequently in the iridotomy failure group as compared with the iridotomy success group (4/7 vs. 1/15, p = 0.02). Dilated, miotic-resistant pupils were observed only in the iridotomy failure group (4/7 vs. 0/15, p = 0.004). PAS greater than 50% and dilated, fixed pupils were observed in these same cases (4 eyes). Our results suggest that laser iridotomy may not be helpful in cases with dilated and miotic-resistant pupils with formation of extensive PAS.
authors.affiliation: Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Y Y
authors.initials: YY
authors.lastname: Kim
authors.forename: H R
authors.initials: HR
authors.lastname: Jung
mesh_terms: D000368:Aged; D004351:Drug Resistance; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D007498:Iris / Q000601:surgery*; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D008916:Miotics / Q000627:therapeutic use*; D011680:Pupil / Q000187:drug effects*; D012086:Reoperation; D012189:Retrospective Studies; D014130:Trabeculectomy; D017211:Treatment Failure
chemical_list: D008916:Miotics