Long-term Intraocular Pressure Change in Attacked and Fellow eyes with Acute Angle-closure Glaucoma after Laser Iridotomy

ABSTRACT

PURPOSE: To study long-term change of intraocular pressure (IOP) in attacked and fellow eyes after laser iridotomy (LI) in the patients with acute angle-closure glaucoma (AACG). METHODS: All eyes of 72 patients were studied for more than 6-month follow-up (range 6-67 months). LI was performed in both eyes. Subsequent long-term IOP change, and additional medical or surgical management were analyzed retrospectively. We defined re-elevation as, (1) IOP greater than 21mmHg or, (2) progression of glaucomatous optic disc change or visual field defect despite initial reduction of IOP after LI. RESULTS: The mean IOP of attacked eyes dropped from 46.6 +/- 16.5 to 13.8 +/- 6.9 mmHg after LI. Among the attacked eyes, 32 (44.4%) required further medical therapy due to re-elevation of IOP, of which 4 (5.6%) eventually underwent operation. Among the fellow eyes, 16 (22.2%) underwent further medical therapy, although none required surgery. CONCLUSIONS: We recommend close, long-term follow-up for patients with AACG, because there is high risk of re-elevation of IOP, despite well-controlled immediate IOP after LI in both attacked and fellow eyes.