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PURPOSE: To determine the survival of Nd:YAG laser peripheral iridotomy in those patients with angle-closure glaucoma and iris bombe associated with uveitis. METHODS: A retrospective review was performed on 11 patients at the Ocular Immunology Clinic of the Royal Victorian Eye and Ear Hospital who presented with uveitis, iris bombe due to extensive posterior synechiae and angle closure glaucoma. The date of iridotomy and where possible the degree of inflammation were noted, as was the date of failure of the iridotomy. A control group was constructed consisting of 65 patients who presented with acute angle closure glaucoma without a history of uveitis, who underwent Nd:YAG peripheral iridotomy. The survival of the peripheral iridotomies in the two groups was calculated using Kaplan-Meier survival analysis. Median survival was compared using log-rank test. RESULTS: In the study group of 11 patients, 28 iridotomies were performed on 15 eyes; of these 28 iridotomies, 17 failed. Using Kaplan-Meier survival analysis the median time to failure was 85 days. In the control group of 65 patients, 66 iridotomies were performed on 66 eyes. None of the iridotomies in the control group failed. There was a significant difference in the survival of the Nd:YAG iridotomies (p = 0.00015) between groups. CONCLUSIONS: There is a high early failure rate of Nd:YAG iridotomies in patients with angle closure glaucoma and iris bombe associated with uveitis.
Dr N.A. Spencer, 29A Mary Street, Hawthorn, Victoria 3122, Australia. matlaw@bigpond.com
9.4.6 Glaucomas associated with inflammation, uveitis (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)