Change in Angle Parameters Measured by Anterior Segment Optical Coherence Tomography after Laser Peripheral Iridotomy Alone versus Laser Peripheral Iridotomy and Argon Laser Peripheral Iridoplasty

PURPOSE: To compare the changes in angle parameters after laser peripheral iridotomy (LPI) alone versus LPI and ALPI (argon laser peripheral iridoplasty) in primary angle closure patients by using anterior segment optical coherence tomography (AS-OCT). METHODS: A total of 25 eyes from 17 patients with narrow angles were enrolled in this present study. Eleven eyes in the LPI treatment group and 14 eyes in the LPI and ALPI combined treatment group were evaluated using AS-OCT. The anterior chamber depth (ACD), angle opening distance at 500 microm (AOD 500) and 750 microm (AOD 750), angle recess area at 500 microm (ARA 500) and 750 microm (ARA 750), trabecular-iris space area at 500 microm (TISA 500) and 750 microm (TISA 750), trabecular-iris angle (TIA) were measured. The pre- and post-treatment parameters were compared in each group. The parameter changes after laser treatment were also compared. RESULTS: AOD 500, AOD 750, ARA 500, ARA 750, TISA 500 and TISA 750 except ACD significantly increased following LPI treatment (p = 0.013, p = 0.010, p = 0.008, p = 0.003, p = 0.006, p = 0.003, p = 0.013, respectively, Wilcoxon signed rank test) and LPI and ALPI combined therapy (p = 0.001, p = 0.001, p = 0.001, p = 0.001, p = 0.001, p = 0.001, p = 0.001, respectively, Wilcoxon signed rank test). The AOD 500 difference, TISA 500 difference, and TISA 750 difference were significantly greater after LPI and ALPI combined therapy than after LPI treatment alone (p = 0.112, p = 0.147, p = 0.049, p = 0.037, respectively, Mann-Whitney U-test). CONCLUSIONS: The results from the present study showed LPI alone or LPI and ALPI combined therapy significantly widened the anterior chamber angle and combined therapy showed greater effect than LPI alone.

Effect of Combined Argon Laser Peripheral Iridoplasty and Laser Iridotomy in Primary Angle-Closure Glaucoma

PURPOSE: To assess the effect of argon laser peripheral iridoplasty in patients with primary angle-closure glaucoma. METHODS: Eyes of 63 patients with primary angle-closure glaucoma who needed laser therapy were evaluated. We divided the patients randomly into two groups and studied prospectively. Thirty eyes (30 patients) were treated with both laser iridotomy and argon laser peripheral iridoplasty. Thirty-three eyes (33 patients) were treated with only laser iridotomy. Anti-glaucoma drugs were not used after laser therapy, and intraocualr pressure (IOP) over 21 mmHg during follow-up period were considered as failure. RESULTS: No differences were found between the two groups in age, sex, initial IOP, clinical forms of angle closure, degrees of peripheral antirior synechiae, and follow-up period. Patients treated with argon laser peripheral iridoplasty and laser iridotomy had successfully controlled IOPs (<21 mmHg) than those with only laser iridotomy through 8 months after laser therapy (p<0.05, log-rank test). However, there was no difference in the two groups at the final follow-up months (12 months) (p=0.180, log-rank test). CONCLUSIONS: Argon laser pheripheral iridoplasty decreased IOP in the early post-laser period. However, in the long term follow-up, the effect of argon laser pheripheral iridoplasty did not last when compared with laser iridotomy.

Effectiveness of Argon Laser Peripheral Iridoplasty in the Treatment of Severe Acute Angle-Closure Glaucoma

We used argon laser peripheral iridoplasty to reduce intraocular pressure[IOP] in acute angle-closure glaucoma[ACG] which is unrelieved by medical and physical treatments and could not be treated by peripheral iridotomy due to edematous cornea and turbid aqueous. Eight of 16 eyes [16 patients] were successfully treated. These successfully treated eyes had a mean duration of angle closure of 4.1 days and 8 unsuccessfully treated eyes 9.2 days. The 6 eyes of 8 eyes with successful reduction of IOP after argon laser peripheral iridoplasty were treated peripheral iridotomy at average 1.7 day later and had deep anterior chamber. After a mean follow-up period of 2 months, 7 of these 8 successfully treated eyes had an IOP less than or equal to 21mmHg. Argon laser pripheral iridoplasty may be successful in treating ACG which is unrelieved by medical and physical treatments and could not be treated by pripheral iridotomy, especially in cases that are recognized and treated soon after onset.

Argon Laser Peripheral Iridoplasty in Angle-Closure Glaucoma

The purpose of this study is to evaluate the clinical factors in eye with continued appositional angle closure in the presence of a patent iridectomy and the clinical avaiability of argon laser peripheral iridoplasty(ALPI). In this study we retrospectively reviewed the outcome in 59 eyes of 32 patients who underwent iridectomy. After Dark Room Prone-position Test(DRPT), 15 eyes among 59 eyes(25.4%) showed DRPT positive and ALPI was successfully performed in 13 eyes among these 15 eyes(86.7%). Patients with DRPT positive were younger than those with DRPT negative. One eye had postoperative complication; iritis more than 1 week. In this study it was found that Argon lader peripheral iridoplasty is a Safe and an effective means of opening an appositionally closed angle in situations in which laser ridotomy does not physically eliminate appositional angle closure.