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Abstract #9843 Published in IGR 5-3
Acute angle-closure glaucoma despite previous Nd:YAG laser iridotomy: a report on 13 cases
Tanasescu I; Grehn FOphthalmologe 2003; 100: 832-835
BACKGROUND: Nd:YAG laser iridotomy is routinely used as a procedure for primary acute angle-closure glaucoma (AACG). The clear advantage of Nd:YAG laser iridotomy is to resolve pupillary block without opening the eye. Nevertheless, it remains unclear whether Nd:YAG laser iridotomy is equally effective as surgical iridectomy. In this context, cases in which AACG recurred despite patent Nd:YAG laser iridotomy are of interest. PATIENTS AND METHODS: In a retrospective study, the authors analyzed the charts of 90 patients who presented with unilateral primary AACG in their department over three years and were treated with a surgical iridectomy. Surgical iridectomy at the 12 o'clock position was performed using a self-sealing corneal incision. RESULTS: Of the 90 patients with primary AACG, 13 (14.4%) had already been treated with Nd:YAG laser iridotomy. Despite the laser iridotomy, these eyes developed recurrent AACG. The presenting intraocular pressure (IOP) of these 13 eyes was 49.07±12.65 mmHg. In four eyes, continuous medical glaucoma therapy was used prior to AACG, eight eyes showed signs of glaucoma damage at the optic disc or/and the visual field. In two eyes, the presenting high IOP at AACG could be lowered by medication. All other eyes were operated on at high IOP. The average interval between the Nd:YAG laser iridotomy and the AACG was 24.5 weeks. After surgical iridectomy, the IOP was reduced to 12.69±4.11 mmHg and was 16.62±3.86 mmHg at the end of the observation period. CONCLUSIONS: Despite Nd:YAG laser iridotomy, recurrent AACG can occur. Surgical iridectomy is capable of permanently resolving the pupillar block in these cases. LA: German
Dr. I. Tanasescu, Universitats-Augenklinik Wurzburg, Josef-Schneider-Strasse 11, 97080 Wurzburg, Germany
Classification:
9.3.1 Acute primary angle closure glaucoma (pupillary block) (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)
12.2 Laser iridotomy (Part of: 12 Surgical treatment)
