Corneal endothelial damage after neodymium:YAG laser iridotomy.
OBJECTIVE
This study examined the long-term effect of neodynium:YAG (Nd:YAG) laser iridotomy on the corneal endothelium.


METHODS
A prospective study was designed. Patients with narrow and occludable angles or fellow eye of acute angle closure glaucoma attack were treated with Nd:YAG laser iridotomy. For one year, 31 eyes of 21 patients underwent complete follow-up. Corneal endothelial specular microscopy was performed before and after laser iridotomy at 1, 3, 6, and 12 months.


RESULTS
The decrease of endothelial cell density after YAG laser iridotomy was statistically significant at 1 month (P = 0.036), 6 months (P = 0.004), and 12 months (P = 0.000), respectively. The decrease was not statistically significant at 3 months (P = 0.467). Linear regression analysis indicated no statistical correlation between the percentage change in endothelial cell density and the total energy used during the treatment (1 month: P=0.08, 3 months: P= 0.3, 6 months: P=0.9, 12 months: P=0.2).


CONCLUSIONS
This study demonstrated significant endothelial cell loss in the 1-year follow-up. The result suggested that Nd:YAG laser iridotomy may pose a long-term hazard to the corneal endothelium.
Wu
S C
SC
Department of Ophthalmology, Chang Gung Memorial Hospital, Taipei, Taiwan.
Jeng
S
S
Huang
S C
SC
Lin
S M
SM
D000328:Adult; D000368:Aged; D002452:Cell Count; D004728:Endothelium, Corneal / Q000293:injuries* / Q000473:pathology; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000473:pathology / Q000601:surgery*; D005902:Glaucoma, Open-Angle / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D007498:Iris / Q000601:surgery*; D053685:Laser Therapy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies