Sequential Argon and Nd : YAG Laser Iridotomies in Angle Closure Glaucoma

ABSTRACT

A retrospective clinical study to evaluate the use of the argon and Nd YAG laser in sequential combination for iridotomy was carried out on 29 eyes of 19 patients with angle closure glaucoma. The argon laser settings were standardized at 0.01-0.02 second duration and 50 micrometerspot size. The total mean energies for the argon and Nd YAG stages were 2.7 +/-1.49J and 9.0 +/-5.83 mJ respectively. Mean postoperative decrease of intraocular pressure(IOP)was 26.4 +/-20.14 mmHg. Postoperative complications were bleeding at iridotomy site (3 eyes),transient increse in IOP (2 eyes),and posterior synechia (1 eye),but there was no lenticularopacity,and no closure of the iridotomy site. The laser iridotomy using sequential argon and Nd YAG laser is an effective method in dark irides, lowering the mean total energy delivered per eye by the argon and YAG laser repectively, combining the advantages of both laser procedures while avoiding most of the disadvantages. We think that it is the more safe and effective method with the decreased mean total energy of argon laser at 0.01-0.02 second duration, 50 micrometerspot size followed by YAG laser.