| Title | YAG laser iridotomy treatment for primary angle closure in east Asian eyes. | | Author(s) | Nolan WP, Foster PJ, Devereux JG, Uranchimeg D, Johnson GJ, Baasanhu J | | Institution | Department of Epidemiology and International Eye Health, Institute of Ophthalmology, University College, London, UK. w.nolan@ucl.ac.uk | | Source | Br J Ophthalmol 2000 Nov; 84(11):1255-9. | | MeSH | Adult
Aged
Female
Follow-Up Studies
Glaucoma, Angle-Closure
Humans
Intraocular Pressure
Laser Surgery
Male
Middle Aged
Mongolia
Observer Variation
Research Support, Non-U.S. Gov't
Treatment Outcome
Visual Acuity
| | Abstract | AIM: To assess the efficacy of Nd:YAG laser iridotomy as initial treatment for primary angle closure in a community setting in rural Mongolia.
METHODS: Subjects with occludable drainage angles in two glaucoma prevalence surveys in Mongolia (carried out in 1995 and 1997) were treated with YAG laser iridotomy at the time of diagnosis. These patients were re-examined in 1998. Patency of iridotomy, intraocular pressure (IOP), visual acuity, and gonioscopic findings were recorded. Iridotomy was classified unsuccessful in eyes where further surgical intervention was required or in which there was a loss of visual acuity to <3/60 from glaucomatous optic neuropathy.
RESULTS: 164 eyes of 98 subjects were examined. Patent peripheral iridotomies were found in 98.1% (157/160) of eyes that had not undergone surgery. Median angle width increased by two Shaffer grades following iridotomy. Iridotomy alone failed in 3% eyes with narrow drainage angles and either peripheral anterior synechiae or raised IOP, but normal optic discs and visual fields. However, in eyes with established glaucomatous optic neuropathy at diagnosis iridotomy failed in 47%. None of the eyes with occludable angles that were normal in all other respects, and underwent iridotomy, developed glaucomatous optic neuropathy or symptomatic angle closure within the follow up period.
CONCLUSIONS: Nd: YAG laser iridotomy is effective in widening the drainage angle and reducing elevated IOP in east Asian people with primary angle closure. This suggests that pupil block is a significant mechanism causing closure of the angle in this population. Once glaucomatous optic neuropathy associated with synechial angle closure has occurred, iridotomy alone is less effective at controlling IOP. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 11049950 |
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