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In acute angle-closure glaucoma cases, surgical iridectomy has been superseded by Nd:YAG laser iridotomy, because the laser procedure is much safer. Opening the globe for a surgical iridectomy in a patient with high intraocular pressure greatly increases the risk of suprachoroidal hemorrhage , with potential for associated expulsive hemorrhage .
A laser peripheral iridotomy (LPI) is the application of a laser beam to selectively burn a hole through the iris near its base. LPI may be performed with either an argon laser or Nd:YAG laser. [6] [7] There is currently no sufficient evidence to show any benefit on the use of iridotomy versus no iridotomy to slow down visual field loss.
If narrow angle glaucoma persists after iridotomy, it is called plateau iris syndrome and subsequently managed either medically (miotics) or surgically (laser peripheral iridoplasty). This condition is sometimes discovered after an iridotomy causes a rapid increase in eye pressure. [1]
Surgical iridectomy can be done manually or with a Nd:YAG laser. Laser peripheral iridotomy may be done either before or following cataract surgery. [87] Swelling of the macula, the central part of the retina, results in macular oedema and can occur a few days or weeks after surgery. Most such cases can be successfully treated.
A 2016 Cochrane Review sought to determine the effectiveness of YAG laser iridotomy versus no laser iridotomy for pigment dispersion syndrome and pigmentary glaucoma, in 195 participants, across five studies. [5] No clear benefits in preventing loss of visual field were found for eyes treated with peripheral laser iridotomy. [5]
Laser peripheral iridotomy has high efficacy in the treatment of pigmentary glaucoma. Argon laser trabeculoplasty is effective in the management of corticosteroid and pigmentary glaucoma. [ 2 ] However, this is often contraindicated due to high rates of failure in patients with uveitic glaucoma. [ 6 ]
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Phacomorphic glaucoma is an eye disease that can occur due to a neglected advanced cataract.In this, the mature cataractous lens cause secondary angle closure glaucoma.The presence of an asymmetric mature cataractous lens, shallow or closed anterior chamber angle, raised intraocular pressure (IOP) and other typical signs and symptoms of angle-closure glaucoma in the eye may lead to a diagnosis ...