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In acute angle-closure glaucoma cases, surgical iridectomy has been superseded by Nd:YAG laser iridotomy, because the laser procedure is much safer.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 .
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 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.
Risk factors for secondary glaucoma include uveitis, [1] cataract surgery [5] and also intraocular tumours. [5] Common treatments are designed according to the type (open-angle or angle-closure) and the underlying causative condition, in addition to the consequent rise in IOP. These include drug therapy, the use of miotics, surgery or laser ...
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]
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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]