Downloads: 1 | Views: 118 | Weekly Hits: ⮙1 | Monthly Hits: ⮙1
Analysis Study Research Paper | Ophthalmology | India | Volume 12 Issue 3, March 2023 | Rating: 5 / 10
The Study of Effects of Nd: Yag Laser Peripheral Iridotomy on Refraction, Gonioscopy and Intraocular Pressure in the Spectrum of Primary Angle Closure Glaucoma
Dr. D. Swetha | Dr. D. Udayakumar [3] | Dr. Neelapareddy Likhitha Reddy
Abstract: Introduction: Glaucoma is currently one of the leading cause of irreversible blindness worldwide. Glaucoma is becoming more prevalent and is anticipated to impact 111.8 million individuals globally by 2040. People with PACG are 2.5 times more likely to become blind than those with POAG. The most common procedure for angle closure is Neodymium: yttrium-aluminum-garnet (Nd: YAG) laser peripheral iridotomy (LPI). Peripheral iridotomy (PI) acts by eliminating relative pupil block which is the mechanism underlying the development of angle closure. Thus, in our country where PAC spectrum disease accounts for almost 50% of the case load of glaucoma, the effectiveness of LPI as the first-line treatment for PAC spectrum eyes needs to be evaluated. Objectives: To evaluate the effects of laser peripheral iridotomy on intra ocular pressure (IOP), gonioscopy and refraction in cases diagnosed as Primary angle closure disease (PACD). Materials and Methods: We conducted a Hospital-based, prospective, interventional study during a study period from October 2021 to September 2022. During our study period, we evaluated a total of 100 eyes diagnosed as having Primary angle closure disease and treated them with Nd: YAG laser peripheral iridotomy. All 100 eyes were closely followed upto document the changes in IOP, gonioscopy grading and refraction. Results: Post LPI, we observed that overall there was a significant reduction of IOP. The values declined to a mean IOP of 19.25 ?9.35 mmHg during week one follow up and further reduced to18.83?9.47mmHg by one-month post-procedure. We observed that in PACG cases LPI was alone, not effective in controlling the IOP. During our final follow up, 35 eyes had angles narrow angles without peripheral anterior synechiae (PAS) i.e.>270 degrees of iridotrabecular contact (ITC) without PAS, open on indentation and 30 eyes had <270 degrees of ITC and were considered occludable angles. 35 eyes had persistent narrow angles with PAS i.e. >270 degrees of ITC with PAS. All these 35 cases with persistent narrow angles had significant PAS of ? 6 clock hours. There was no statistically significant change in the refraction post LPI. Conclusion: LPI as a single effective procedure was successful in controlling IOP and gonioscopic improvement of angle grades was seen in all PACS cases and PAC cases which had less than six clock hours of PAS. In PAC and PACG cases with more than six clock hours of PAS, LPI alone was not effective and such cases required additional treatment for glaucoma management. LPI does not alter there fractive status of the eyes.
Keywords: PACS, PAC, PACG, Nd: YAGLPI, Gonioscopy, IOP
Edition: Volume 12 Issue 3, March 2023,
Pages: 874 - 881