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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.
In acute angle-closure glaucoma cases, surgical iridectomy has been superseded by Nd:YAG laser iridotomy, because the laser procedure is much safer.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 .
Plateau iris is a medical condition of the eye resulting from anterior displacement of the peripheral iris by the ciliary body, causing angle closure glaucoma. First line treatment for all causes of narrow angle glaucoma is laser iridotomy.
The Nd:YAG laser is the most common laser used in laser designators and laser rangefinders. During the Iran–Iraq War, Iranian soldiers suffered more than 4000 cases of laser eye injury, caused by a variety of Iraqi sources including tank rangefinders. The 1064 nm wavelength of Nd:YAG is thought to be particularly dangerous, as it is invisible ...
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 ]
Nd:YAG laser peripheral iridotomy (LPI) may be used in patients susceptible to or affected by angle closure glaucoma or pigment dispersion syndrome. During laser iridotomy, laser energy is used to make a small, full-thickness opening in the iris to equalize the pressure between the front and back of the iris, thus correcting any abnormal ...
Occasionally, a peripheral iridectomy may be made to minimize the risk of pupillary block glaucoma. [7] 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]