Journal d'ophtalmologie clinique et expérimentale
Libre accès

Abstrait

Effectiveness of Argon Laser Peripheral Iridoplasty in Plateau Iris Syndrome Patients after Laser Peripheral Iridotomy

Emma Klug, Marika Chachanidze, Abraham Nirappel, Nathan Hall, Ta C Chang, David Sol�?¡-Del Valle

Objective: There is controversy surrounding the next best step in treating plateau iris syndrome (PIS) patients with persistent angle dysfunction despite a patent laser peripheral iridotomy (LPI). The aim of this study was to examine the effectiveness of argon laser peripheral iridoplasty (ALPI) in PIS patients with a patent LPI.
Methods: Retrospective review of medical records in consecutive patients that underwent ALPI to treat persistently narrow angles due to underlying PIS after a patent LPI. Patients in whom angle configuration could not be ascertained by review of medical records, those with less than 12 months follow-up at our institution, or those younger than 18 years of age were excluded. Kaplan-Meier survival analysis was used to determine treatment survival time. Paired t-tests were used to compare intraocular pressure (IOP), number of glaucoma medications, and bestcorrected visual acuity (BCVA) 12 months post-ALPI and at the last follow-up visit.
Results: Fifty-one eyes of 51 patients were included in the analysis. The median survival time for a successful ALPI procedure was 1023 days (34.1 months). The majority of failure events were attributed to cataract extraction to open a persistently narrow angle, performed at approximately 934 (± 694) days (31.1 months) after ALPI. No changes in IOP, number of glaucoma medications, or BCVA from baseline were observed after 12 months or at last follow-up.
Conclusion: ALPI is a potentially effective treatment for PIS following LPI. While angle dysfunction may re-emerge over time, ALPI can potentially delay the need for lensectomy in patients without visually significant cataracts.