Mid-term follow-up of Nd:YAG laser iridotomy in Asian eyes.
OBJECTIVE
To assess the long-term results of Nd:YAG laser iridotomy in the treatment of patients with primary angle-closure glaucoma and occludable angles to evaluate the risk-benefit ratio and the role of gonioscopy in predicting the outcome after Nd:YAG laser iridotomy.


METHODS
The records of 138 consecutive patients (231 eyes) who underwent Nd:YAG laser iridotomy in one hospital during 3 years (from 1989 to 1991) were reviewed. The mean follow-up period was 51 months.


RESULTS
Of all eyes, 25.1% were treated for chronic angle-closure glaucoma and 10.8% were treated for acute angle-closure glaucoma; most eyes (64.1%) underwent prophylactic iridotomy for occludable angles. Decreased intraocular pressure (IOP) was noted in most eyes after Nd:YAG laser iridotomy; only 10 eyes required further filtration surgery. Visual acuity was unchanged or improved in 97.9% of all eyes at the 6-month visit. Cataract progression was primarily responsible for those eyes with decreased acuity. Ninety-seven percent of eyes had quantitatively wider angles after laser treatment; 8 of 14 eyes with peripheral anterior synechiae of more than 270 degrees underwent further surgery to control IOP. Transient elevated IOP and iris bleeding occurred in 23.5% and 12.2% of the eyes, respectively; other complications were rare.


CONCLUSIONS
Nd:YAG laser iridotomy is a safe and effective procedure for the treatment and prevention of angle-closure glaucoma. Gonioscopy is useful to predict the outcome after Nd:YAG laser iridotomy.
Hsiao
Ching-Hsi
CH
Department of Ophthalmology, Chang-Gung Memorial Hospital, Taipei, Taiwan.
Hsu
Ching-Tarng
CT
Shen
Su-Chin
SC
Chen
Henry S L
HS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D005006:Ethnicity; D005260:Female; D018463:Filtering Surgery; D005500:Follow-Up Studies; D015812:Glaucoma, Angle-Closure / Q000473:pathology / Q000503:physiopathology / Q000517:prevention & control / Q000601:surgery*; D006068:Gonioscopy; D006801:Humans; D007429:Intraocular Pressure; D007498:Iris / Q000601:surgery*; D053685:Laser Therapy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011315:Preventive Medicine / Q000379:methods; D011379:Prognosis; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity