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Laser peripheral iridotomy

Yana Fu, Wuying Zhou, Wei Li, Xiaolei Lin, Qi Dai
RATIONALE: The incidence of cornea disorders after laser peripheral iridotomy (LPI) is extremely low. However, cornea Descemet membrane detachment (DMD) combined with corneal decompensation after LPI could still occur. PATIENT CONCERNS: A 69-year-old Chinese woman presented with persistent widespread corneal edema and inferior bullous lesions in her right eye for half a year. She had undergone LPI in both eyes 10 years ago for a prophylactic treatment. The patient received a detailed examination of vivo corneal confocal microscopy and sept-source optical coherence tomography (SS-OCT)...
March 2018: Medicine (Baltimore)
Sunita Radhakrishnan, Philip P Chen, Anna K Junk, Kouros Nouri-Mahdavi, Teresa C Chen
PURPOSE: To examine the efficacy and complications of laser peripheral iridotomy (LPI) in subjects with primary angle closure (PAC). METHODS: Literature searches in the PubMed and Cochrane databases were last conducted in August 2017 and yielded 300 unique citations. Of these, 36 met the inclusion criteria and were rated according to the strength of evidence; 6 articles were rated level I, 11 articles were rated level II, and 19 articles were rated level III. RESULTS: Reported outcomes were change in angle width, effect on intraocular pressure (IOP) control, disease progression, and complications...
February 23, 2018: Ophthalmology
Tarannum Mansoori, Satish Gooty Agraharam
PURPOSE: To report an interesting phenomenon, after vitreoretinal surgery, in an eye with toric implantable collamer lens (ICL). METHODS: A 20-year-old male presented with raised intraocular pressure (IOP) after the retinal detachment surgery in the left eye. He had toric ICL in both the eyes, and left eye showed shallow peripheral anterior chamber depth (ACD), narrow iridocorneal angle (ICA), increased ICL vault and pigments debris blocking central hole. After dilation, peripheral ACD deepened, ICL vault decreased and ICA increased, with posterior bowing of iris...
February 24, 2018: International Ophthalmology
Jie Wang, Ergang Du, Jinfei Tang
BACKGROUND: The management of eyes with nanophthalmos is a dilemma for ophthalmologists due to various complications, especial the eye with malignant glaucoma. We report a case of effective treatment for malignant glaucoma in nanophthalmos. CASE PRESENTATION: An 82-year-old man was performed phacoemulsification in the right eye with normal ocular pressure and nanophthalmos. The surgery was uneventful: an intraocular lens (IOL) was placed and centered in the capsular bag...
February 23, 2018: BMC Ophthalmology
Anis Mahmoud, Fatma Abid, Imen Ksiaa, Sourour Zina, Riadh Messaoud, Moncef Khairallah
BACKGROUND: To report a case of bilateral acute angle closure-glaucoma following the use of subcutaneous Tramadol. CASE PRESENTATION: A 42-year-old healthy man with unremarkable past medical and ocular history, was admitted to the Orthopedic Department for surgical treatment of a bilateral open fracture of the femur following a road accident. Three hoursafterTramadolsubcutaneous injection, the patient complained of a bilateral acute painful visual loss with persistent vomiting...
February 17, 2018: BMC Ophthalmology
Alexander C Day, David Cooper, Jennifer Burr, Paul J Foster, David S Friedman, Gus Gazzard, Jemaima Che-Hamzah, Tin Aung, Craig R Ramsay, Augusto Azuara-Blanco
BACKGROUND: To describe the surgical technique and refractive outcomes following clear lens extraction (CLE) in the Effectiveness, in Angle-closure Glaucoma, of Lens Extraction trial. METHODS: Review of prospectively collected data from a multicentre, randomised controlled trial comparing CLE and laser peripheral iridotomy. Eligible participants were ≥50 years old and newly diagnosed with (1) primary angle closure (PAC) with intraocular pressure above 30 mm Hg or (2) PAC glaucoma...
February 16, 2018: British Journal of Ophthalmology
Crenguța Feraru, Andrei Bâlha, Victor Aursulesei, Andrei Filip, Anca Pantalon
We present the therapeutic options and functional results in patients with plateau iris (syndrome or configuration) in consecutive case series. Material and method: Our study included newly diagnosed patients with acute angle closure by "plateau iris" (configuration or syndrome), between June 2016 and April 2017. Series of 8 consecutive patients met the inclusion criteria, all being females. All the patients underwent an individualized treatment according to the underlying mechanism and evolution...
April 2017: Romanian Journal of Ophthalmology
Mengwei Li, Yuhong Chen, Xiaoxiao Chen, Wenqing Zhu, Xueli Chen, Xiaolei Wang, Yuan Fang, Xiangmei Kong, Yi Dai, Junyi Chen, Xinghuai Sun
PURPOSE: To compare various biometric parameters between fellow eyes of acute primary angle closure (glaucoma) [APAC(G)] and fellow eyes of chronic primary angle closure (glaucoma) [CPAC(G)]. METHODS: Ultrasound biomicroscopy examinations were performed on 47 patients with unilateral APAC(G) and 41 patients with asymmetric CPAC(G) before laser peripheral iridotomy and pilocarpine treatment. Anterior chamber depth and width (ACD and ACW), lens vault (LV), iris curvature (IC), iris root distance (IRD), trabecular-ciliary process distance (TCPD), iris-ciliary process distance (ICPD), trabecular-ciliary angle (TCA), and other biometric parameters were compared between fellow eyes of APAC(G) and fellow eyes of CAPC(G)...
2018: PloS One
Takashi Ono, Masaharu Iida, Toshihiro Sakisaka, Keiichiro Minami, Kazunori Miyata
PURPOSE: To evaluate the changes in corneal endothelial cell density (ECD) over a 7-year period after laser peripheral iridotomy (LPI) using argon and neodymium-doped yttrium aluminum garnet (Nd:YAG) lasers. STUDY DESIGN: Retrospective case series. METHODS: Eyes that underwent prophylactic LPI using argon and Nd:YAG lasers were followed up for 7 years. Central corneal endothelial cells were observed by use of noncontact specular microscopy preoperatively and at 1 and 7 years postoperatively...
February 6, 2018: Japanese Journal of Ophthalmology
M Reza Razeghinejad, Parisa Karampour, Masoumeh Beigom Masoumpour, Zahra Tajbakhsh, M Hossein Nowroozzadeh
SIGNIFICANCE: Intraocular pressure and ocular biometric changes were similar before and after laser iridotomy in response to the water-drinking test in a cohort of patients at risk of angle closure. The water-drinking test does not seem to be a good provocative test to determine which eyes would benefit from a laser iridotomy. Our data call into question the preoperative predictive value of this test. PURPOSE: The aim of this study was to evaluate the effect of water-drinking test on intraocular pressure and ocular biometric parameters, before and after laser peripheral iridotomy, in patients with an occludable angle...
February 2018: Optometry and Vision Science: Official Publication of the American Academy of Optometry
Jenny Bo, Tulsi Changulani, Mei-Ling Cheng, Andrew J Tatham
PURPOSE: To examine the outcome of laser peripheral iridotomy (LPI) for primary angle closure and determine predictors of future lens extraction (LE). METHODS: A retrospective chart review of 218 eyes from 128 consecutive patients undergoing LPI between 2010 and 2012 at a university hospital. Baseline factors including age, peak intraocular pressure (IOP) before LPI, diagnosis (primary angle closure suspect, primary angle closure, primary angle closure glaucoma), and acute or non-acute presentation were recorded...
March 2018: Journal of Glaucoma
Pablo Romero, Pradtana Hirunpatravong, Reza Alizadeh, Eun-Ah Kim, Kouros Nouri-Mahdavi, Esteban Morales, Simon K Law, Joseph Caprioli
PURPOSE: There are no reported large series of trabeculectomy with mitomycin-C (MMC) in Western patients with primary angle-closure glaucoma (PACG). Our study evaluates long-term tonometric outcomes of trabeculectomy in PACG. METHODS: This is a retrospective cohort study. The primary outcomes were the Kaplan-Meier success rates on survival analyses using three criteria, with or without adjunctive medication: (A) intraocular pressure (IOP) ≤18▒mmHg and IOP reduction of 20%; (B) IOP≤15▒mmHg and IOP reduction 25%; and (C) IOP≤12▒mmHg and IOP reduction 30%...
December 13, 2017: Journal of Glaucoma
Jeffrey Chi Wang Chan, Bonnie Nga Kwan Choy, Orlando Chia Chieh Chan, Kenneth Kai Wang Li
PURPOSE: Our purpose was to assess the early intraocular pressure (IOP) changes of ultralow fluence laser iridotomy using pattern scanning laser followed by neodymium:yttrium-aluminum-gamet (Nd:YAG) laser. METHODS: This is a prospective interventional study. Thirty-three eyes of 33 adult Chinese primary angle-closure suspect subjects were recruited for prophylactic laser peripheral iridotomy. Sequential laser peripheral iridotomy was performed using pattern scanning laser followed by Nd:YAG laser...
February 2018: Graefe's Archive for Clinical and Experimental Ophthalmology
Maria L Napier, Augusto Azuara-Blanco
PURPOSE OF REVIEW: Angle closure glaucoma is a leading cause of blindness globally and trends of how best to treat this disease are evolving. The advent of anterior segment imaging aids our understanding of pathogenesis and allows more robust and objective measurement of treatment modalities. We will also review recent literature regarding the role of laser and surgical interventions for the treatment of primary angle closure disease. RECENT FINDINGS: Recent studies evaluating the efficacy of laser peripheral iridotomy (LPI) in primary angle closure suspects (PACs) show that while it is a safe intervention and initially anterior chamber angle widens following the laser treatment, the effect is lost with time...
March 2018: Current Opinion in Ophthalmology
Sasan Moghimi, Faezeh Bijani, Rebecca Chen, Mehdi Yasseri, Mingguang He, Shan C Lin, Robert N Weinreb
PURPOSE: To compare the change in anterior segment morphology after laser peripheral iridotomy (LPI) in acute primary angle closure (APAC) and their fellow eyes. DESIGN: Prospective, fellow eye-matched case series. METHODS: In this study 42 individuals with unilateral episode of APAC were enrolled and the anterior segment optical coherence tomography (ASOCT) images were obtained in both eyes at baseline and at 6 weeks after LPI. A linear mixed-effects model was used to compare changes in anterior chamber and angle variables with consideration of laterality as the random effect and pupil diameter as the fixed effect...
February 2018: American Journal of Ophthalmology
Elizabeth Shen, Sarah Farukhi, Mason Schmutz, Sameh Mosaed
PURPOSE OF THE STUDY: The purpose of this study was to report a novel case of drug-induced angle-closure from aripiprazole (Abilify), an atypical antipsychotic, and propose a mechanism for this association. METHODS/RESULTS: We report a case of a 45-year-old white woman who presented in subacute angle closure 2 months after initiating aripiprazole 5 mg daily for depression. This patient reported no prior ocular history and had been on longstanding duloxetine (Cymbalta) 60 mg daily for over 10 years before starting aripiprazole...
February 2018: Journal of Glaucoma
Mazen Amro, Ali A Haydar, Sylvain El-Khoury, Karim F Tomey, George Cherfan, Ziad Khoueir
PURPOSE: The purpose of this study was to report an unusual first manifestation of Coats' disease presenting as an acute angle-closure glaucoma attack in an adult patient. PATIENTS AND METHODS: A 37-year-old African woman presented to the emergency department with severe headache, ocular pain, and no light perception in the left eye. The left pupil was middilated and nonreactive, and the intraocular pressure (IOP) by applanation tonometry was 47 mm Hg. Slit-lamp examination revealed anterior subcapsular opacification (glaukomflecken), posterior synechiae, and total angle closure with iris bombé...
February 2018: Journal of Glaucoma
Joobin Hooshmand, James Cy Leong, Jeremy O'Connor, Ghee S Ang, Anthony P Wells
Aim: To evaluate by anterior segment optical coherence tomography (AS-OCT) the medium-term (mean duration 3.2 years) anatomical changes in the anterior chamber angle (ACA) after laser peripheral iridoplasty. Materials and methods: This is a longitudinal, retrospective case series of 31 eyes of 31 patients with primary angle-closure suspicion, primary angle closure (PAC), or primary angle-closure glaucoma (PACG) who underwent laser peripheral iridoplasty. All patients had persistent iridotrabecular contact (ITC) despite the presence of a patent peripheral iridotomy (PI)...
September 2017: Journal of Current Glaucoma Practice
Tarannum Mansoori, Nagalla Balakrishna
Aim: To evaluate the configuration of the anterior chamber angle quantitatively and study the morphological changes in the eye with ultrasound biomicroscopy (UBM) in primary angle closure glaucoma (PACG) patients after laser peripheral iridotomy (LPI). Materials and methods: A total of 185 eyes of 185 PACG patients post-LPI and 126 eyes of 126 normal subjects were included in this prospective study. All subjects underwent complete ophthalmic evaluation, A-scan biometry, and UBM...
September 2017: Journal of Current Glaucoma Practice
Tarannum Mansoori, Nagalla Balakrishna
PURPOSE: To evaluate and compare the changes in anterior segment parameters in primary angle closure suspects before and after laser peripheral iridotomy and intrasession repeatability of measurements before laser iridotomy as assessed by Scheimpflug-Placido disc topographer. METHODS: Before laser iridotomy, 56 eyes of 56 primary angle closure suspect patients underwent anterior segment analysis with the Sirius Scheimpflug-Placido disc topographer system using glaucoma analysis mode, which was repeated a week after iridotomy...
November 12, 2017: Clinical & Experimental Optometry: Journal of the Australian Optometrical Association
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