Jamshed Ahmed, Sorath Noorani Siddiqui.
A long term follow-up of laser peripheral iridotomy in acute primary angle closure.
Al-Shifa J Ophthalmol Jan ;7(1):20-4.

Purpose: To determine the success rate and complications of YAG laser peripheral iridotomy during a long term follow up in patients of acute primary angle closure glaucoma. Design: Descriptive prospective case series using a combination of quantitative & qualitative analysis. Participants and Methods: Study was conducted at the Department of Ophthalmology Dow University of Health Sciences; Eye Unit 1, Civil Hospital Karachi between October 2005 and September 2010. Patients were recruited from the outpatient department with a diagnosis of acute primary angle closure. After medical control of intraocular pressure forty eight patients underwent YAG laser peripheral iridotomy with pulse energies ranging from 5–8 mJ. Patients were examined at 1 hour, 1 day, one week, two weeks and 1, 3, 6, months, one year and after two to three years. Findings were recorded on proforma and statistically analyzed. Results: Mean age was 54.6 (± 6.7, range = 45 -74) years. Mean duration of attack was 2.65 (±1.4, range 1-6) days. The commonest intra-operative complication was bleeding from the iris in 33.3% eyes. Mean follow-up period was 48.81(±9.03, range 32-65) months. Thirty six (75%) eyes developed significant cataract. Iridotomy was closed in six (12.6%) eyes. Complete success was observed in 12 (24.5%) eyes. Twenty two (44.9%) eyes required additional anti-glaucoma medication (partial success) while complete failure was observed in 14 (28.6%) eyes. Conclusion: YAG laser peripheral iridotomy is associated with a significant number of short term and long term complications in Asian eyes. Other alternative methods should be taken into consideration to prevent blindness in this part of the world.

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