Effect of position on the safety and efficacy of neodymium-doped: Yttrium aluminium garnet laser peripheral iridotomy in patients with primary angle-closure disease
Purpose: The aim is to evaluate the safety and efficacy of neodymium-doped: yttrium–aluminum–garnet laser peripheral iridotomy (LPI) in the superior versus inferior quadrant in the treatment of primary angle-closure (PAC) disease. Design: Randomized, prospective, single-masked, comparative clinical...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2021-01-01
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| Series: | Kerala Journal of Ophthalmology |
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| Online Access: | http://www.kjophthal.com/article.asp?issn=0976-6677;year=2021;volume=33;issue=2;spage=155;epage=159;aulast=Maiya |
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| author | Anitha S Maiya |
| author_facet | Anitha S Maiya |
| author_sort | Anitha S Maiya |
| collection | DOAJ |
| description | Purpose: The aim is to evaluate the safety and efficacy of neodymium-doped: yttrium–aluminum–garnet laser peripheral iridotomy (LPI) in the superior versus inferior quadrant in the treatment of primary angle-closure (PAC) disease. Design: Randomized, prospective, single-masked, comparative clinical study. Materials and Methods: Patients with PAC or PAC suspects were recruited and randomized to receive LPI in the superior or inferior quadrant in both eyes. Patients were masked to the location of treatment in each eye. The main outcome measures assessed were patency of iridotomy, laser parameters, complications, and visual symptoms between the two groups at 1 week and 1 month after the laser intervention. Results: A total of 100 patients were recruited, 50 into each group. The mean age was 51.46 ± 7.91 years. Average intraocular pressure (IOP) measurements before LPI was 18.24 ± 5.37 mm Hg and 18.6 ± 5.63 mm Hg in superior LPI and inferior LPI eyes, respectively. After LPI, average IOP was 17.4 ± 3.31 mm Hg and 17.1 ± 3.13 mmHg in superior LPI and inferior LPI eyes, respectively. Inferior LPIs required less use of mean total laser energy (P = 0.001) and less number of laser shots (P = 0.016) to perforate the iris tissue. There was a lower incidence of iris bleeding and focal corneal damage at the time of treatment; a lower postlaser iritis and lower need for PI enlargement in the inferior LPI group. All the iridotomies were patent at 1 month follow-up. There was no statistically significant difference between the two groups in terms of the dysphotopsias and visual symptoms experienced after the LPI (P = 0.122). Conclusions: LPI in the inferior quadrant appears to be a safe and efficient alternative to superior LPI with fewer complications in the treatment of PAC disease. Dysphotopsias and visual symptoms following inferior LPI are similar to superior LPI. |
| first_indexed | 2024-12-18T01:13:06Z |
| format | Article |
| id | doaj.art-f549551d08874a0c985228b9d60f8d21 |
| institution | Directory Open Access Journal |
| issn | 0976-6677 |
| language | English |
| last_indexed | 2024-12-18T01:13:06Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Kerala Journal of Ophthalmology |
| spelling | doaj.art-f549551d08874a0c985228b9d60f8d212022-12-21T21:26:03ZengWolters Kluwer Medknow PublicationsKerala Journal of Ophthalmology0976-66772021-01-0133215515910.4103/kjo.kjo_152_20Effect of position on the safety and efficacy of neodymium-doped: Yttrium aluminium garnet laser peripheral iridotomy in patients with primary angle-closure diseaseAnitha S MaiyaPurpose: The aim is to evaluate the safety and efficacy of neodymium-doped: yttrium–aluminum–garnet laser peripheral iridotomy (LPI) in the superior versus inferior quadrant in the treatment of primary angle-closure (PAC) disease. Design: Randomized, prospective, single-masked, comparative clinical study. Materials and Methods: Patients with PAC or PAC suspects were recruited and randomized to receive LPI in the superior or inferior quadrant in both eyes. Patients were masked to the location of treatment in each eye. The main outcome measures assessed were patency of iridotomy, laser parameters, complications, and visual symptoms between the two groups at 1 week and 1 month after the laser intervention. Results: A total of 100 patients were recruited, 50 into each group. The mean age was 51.46 ± 7.91 years. Average intraocular pressure (IOP) measurements before LPI was 18.24 ± 5.37 mm Hg and 18.6 ± 5.63 mm Hg in superior LPI and inferior LPI eyes, respectively. After LPI, average IOP was 17.4 ± 3.31 mm Hg and 17.1 ± 3.13 mmHg in superior LPI and inferior LPI eyes, respectively. Inferior LPIs required less use of mean total laser energy (P = 0.001) and less number of laser shots (P = 0.016) to perforate the iris tissue. There was a lower incidence of iris bleeding and focal corneal damage at the time of treatment; a lower postlaser iritis and lower need for PI enlargement in the inferior LPI group. All the iridotomies were patent at 1 month follow-up. There was no statistically significant difference between the two groups in terms of the dysphotopsias and visual symptoms experienced after the LPI (P = 0.122). Conclusions: LPI in the inferior quadrant appears to be a safe and efficient alternative to superior LPI with fewer complications in the treatment of PAC disease. Dysphotopsias and visual symptoms following inferior LPI are similar to superior LPI.http://www.kjophthal.com/article.asp?issn=0976-6677;year=2021;volume=33;issue=2;spage=155;epage=159;aulast=Maiyadysphotopsiaslaser peripheral iridotomyneodymium: yttrium–aluminum–garnet laserprimary angle-closure suspectprimary angle closure |
| spellingShingle | Anitha S Maiya Effect of position on the safety and efficacy of neodymium-doped: Yttrium aluminium garnet laser peripheral iridotomy in patients with primary angle-closure disease Kerala Journal of Ophthalmology dysphotopsias laser peripheral iridotomy neodymium: yttrium–aluminum–garnet laser primary angle-closure suspect primary angle closure |
| title | Effect of position on the safety and efficacy of neodymium-doped: Yttrium aluminium garnet laser peripheral iridotomy in patients with primary angle-closure disease |
| title_full | Effect of position on the safety and efficacy of neodymium-doped: Yttrium aluminium garnet laser peripheral iridotomy in patients with primary angle-closure disease |
| title_fullStr | Effect of position on the safety and efficacy of neodymium-doped: Yttrium aluminium garnet laser peripheral iridotomy in patients with primary angle-closure disease |
| title_full_unstemmed | Effect of position on the safety and efficacy of neodymium-doped: Yttrium aluminium garnet laser peripheral iridotomy in patients with primary angle-closure disease |
| title_short | Effect of position on the safety and efficacy of neodymium-doped: Yttrium aluminium garnet laser peripheral iridotomy in patients with primary angle-closure disease |
| title_sort | effect of position on the safety and efficacy of neodymium doped yttrium aluminium garnet laser peripheral iridotomy in patients with primary angle closure disease |
| topic | dysphotopsias laser peripheral iridotomy neodymium: yttrium–aluminum–garnet laser primary angle-closure suspect primary angle closure |
| url | http://www.kjophthal.com/article.asp?issn=0976-6677;year=2021;volume=33;issue=2;spage=155;epage=159;aulast=Maiya |
| work_keys_str_mv | AT anithasmaiya effectofpositiononthesafetyandefficacyofneodymiumdopedyttriumaluminiumgarnetlaserperipheraliridotomyinpatientswithprimaryangleclosuredisease |