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Editors Selection IGR 9-4

(Laser) Surgical treatment: Laser iridotomy and temperature

Comment by Kenji Kashiwagi on:

20102 Using pharmacy claims data to study adherence to glaucoma medications: methodology and findings of the Glaucoma Adherence and Persistency Study (GAPS), Friedman DS; Quigley HA; Gelb L et al., Investigative Ophthalmology and Visual Science, 2007; 48: 5052-5057

See also comment(s) by Robert Ritch & Yaniv Barkana •

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One of the most serious complications by laser iridotomy (LI) is bullous keratopathy. Acute rise of intraocular temperature is considered as one of the mechanisms of this complication. Kataoka et al. (1466) reported that a specially designed contact lens in which a cooling system was integrated successfully prevented the acute rise of intraocular temperature and that this contact lens alleviated corneal damage induced by LI as well. The study is limited by the high applied laser power (25.6J).

Increased intraocular temperature during laser iridotomy may cause bullous keratopathy

Moreover, data were not disclosed regarding the prospective change of corneal endothelium damage, the most important issue to elucidate a mechanism of LI-induced bullous keratopathy. This report suggests that it may be better to reduce intraocular temperature during LI, especially in case of eyes that are expected to require high laser power for LI procedure.

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