To study the clinical efficacy of Nd Yag peripheral iridotomy in narrow angle glaucoma

Abstract

: To examine the clinical efficacy of laser peripheral iridotomy (LPI) in subjects with primary angle closure (PAC).134 patients with angle closure glaucoma were included in this retrospective study which was carried out at the glaucoma clinic, department of ophthalmology at DR B.R Ambedkar medical college and hospital over a period of 2 years. A total of 134 patients, 268 eyes were participated in this study. All were treated with LPI. The 268 eyes with Successful opening of angle more than 2 for at least 24 weeks. Follow-up ranged from 4 to 24 weeks. Gonioscopy was performed in each visit to confirm the angle status and patency of iridotomy. Success is defined as opening of more than 2 angles ITC for at least 24 weeks, with no need for further medication or laser treatment.The percentage of open angle at 4 weeks was more 2 angles in 72 eyes(26.9%), ITC>3 angles in 56eyes, (20.9%) and ITC>4 angles in 140 eyes are (52.2%), at 12weeks more 2 angles 48 eyes (17.9%), ITC> 3angles in ,60 eyes (20.9%) ITC>4 angles in 160 eyes (59.7%) and 24 weeks was more 2 angles eyes 28 (10.4%), ITC> 3,60 eyes (22.4%) ITC>4 angle in180 (67.2%). The success rate at 24 weeks ITC more than2 angle was 10.4%, ITC>3angles 22.4% and ITC> 4angles in 67.2% respectively.In all cases, IOP was measured within 1 hour and IOP elevation of greater than 8 mm Hg was observed in eyes (15.7%). Mild-to-moderate anterior chamber reaction is seen in 128 eyes, hyphema in 12 eyes, ghost images seen in 4 eyes, 4cases of macular edema, cataract progression seen in 32 eyes, and iridotomy in 52 eyes were noted.Post laser procedure combination of steroid and antibiotic medication was prescribed for 5 days and IOP pressure more 8 mmHg seen in 42 eyes(15.7%), antiglaucoma medications started and oral T. Diamox 250mg 2 tablets were prescribed followed up after 5 days to reassurance. LPI is an effective treatment option for all patients with in Primary Angle Closure suspect to prevent the acute angle closure glaucoma. LPI is a effective, compliance free, repeatable, most PACS eyes don’t receive further treatment and safe therapeutic modality having only minor, transient, self-limiting or easily controlled side effects with no sequelae. Progression to PACG is uncommon in PACS and PAC. Despite our methodology, the inherent limitations of studies should be considered, and conclusion drawn from our pooled results should be interpreted with caution. Future large-volume, well-designed with extensive follow-up are awaited to confirm and update the findings of this analysis.