Title: The outcome of YAG laser PI (peripheral iridotomy) in management of glaucoma patients in Bangladesh
Authors: Dr Farhat Jahan, Dr Mehbub Ul Kadir, Dr Chandana Sultana, Dr Md. Saifulla
DOI: https://dx.doi.org/10.18535/jmscr/v8i3.30
Abstract
Objective: In this study our main goal is to evaluate the outcome of YAG laser PI (peripheral iridotomy) in management of glaucoma patients in Bangladesh.
Method: This cross-sectional study was done in the in the National Institute of Ophthalmology & Hospital from September 2013 to September 2016. A total of 120 consecutive patients were included. On the basis of Academy of Ophthalmology primary Angle Closure glaucoma preferred practice pattern patients were sub divided into three group: primary angle closure suspect (PACS) (#180° iridotrabecular contact [ITC], normal IOP and no optic nerve damage), n=40: primary angle closure (PAC) ($180° ITC with peripheral anterior synechiae [PAS] or elevated IOP, but no optic neuropathy), n=40; and primary angle closure glaucoma (PACG) ($180° ITC with PAS, elevated IOP and optic neuropathy, n=40.
Results: during the study, 40% percent of the patients had undergone bilateral LPI. mean power used in primary angle closure glaucoma was 130±126.8.3% produced hyphema in 1st year, followed by 1% produced hyphema in 2nd year, no patients found in 3rd year. In primary angle closure suspect cases, 27% had repeated laser peripheral iridotomy, followed 11% in primary angle closure cases and 15% in primary angle closure glaucoma
Conclusion: From our study we can conclude that, laser iridotomy for the clinical treatment of early primary angle-closure glaucoma effectively reduces the intraocular pressure and improves the acuity level of patient. Early treatment by laser iridotomy may also reduce the risk rate to develop primary angle glaucoma. The effective rate of treatment is high, so the treatment improves the quality of life of patients.
Keywords: YAG laser PI (peripheral iridotomy), primary angle closure glaucoma, primary angle closure
References
- Laser peripheral iridotomy for pupillary-block glaucoma. American Academy of Ophthalmology. Ophthalmology. 1994; 101(10):1749–1758.
- Robin AL, Pollack IP. A comparison of neodymium: YAG and argon laser iridotomies. Ophthalmology. 1984;91 (9): 1011–1016.
- Accreditation Council for Graduate Medical Education. ACGME oph-thalmology surgery case logs national data report: 2014–2015. 2015. Available from: http://www.acgme.org/Portals/0/PDFs/240_National_Report_Program_Version.pdf. Accessed May 1, 2017.
- Vera V, Naqi A, Belovay GW, Varma DK, Ahmed II. Dysphotopsia after temporal versus superior laser peripheral iridotomy: a prospective randomized paired eye trial. Am J Ophthalmol. 2014;157(5):929–935.
- Lewis R, Perkins TW, Gangnon R, Kaufman PL, Heatley GA. The rarity of clinically significant rise in intraocular pressure after laser peripheral iridotomy with apraclonidine. Ophthalmology. 1998; 105(12):2256–2259.
- Jiang Y, Chang DS, Foster PJ, et al. Immediate changes in intraocular pressure after laser peripheral iridotomy in primary angle-closure suspects. Ophthalmology. 2012;119(2):283–288.
- Schwartz LW, Moster MR, Spaeth GL, Wilson RP, Poryzees E. Neodymium-YAG laser iridectomies in glaucoma associated with closed or occludable angles. Am J Ophthalmol. 1986; 102 (1):41–44.
- World Health Organization. Fact Sheet No. 282. Visual impairment and blindness June 2012. http://www.who.int/mediacentre/factsheets/fs282/en.Google Scholar.