Laser peripheral iridotomy with and without laser iridoplasty in management of primary angle closure

To compare the efficacy and safety of laser peripheral iridotomy with or without laser peripheral iridoplasty in the treatment of eyes having primary angle closure.

Hundred eyes of 100 patients of primary angle closure were randomized to one of the two treatment options, iridotomy or iridotomy plus iridoplasty, and were followed up for at least 3 months. Main outcome measures were intraocular pressure, irido trabecular contact, peripheral anterior synechiae and complications.

There was no significant difference between the two groups in the baseline data. The IOP was reduced from 24.74+/-6.4 mm Hg to 19.32+/-5.8 mm Hg in iridotomy group (p<0.01) and from 24.12+/-6.4 mm Hg to 17.12+/-8.4 mm Hg in iridotomy plus iridoplasty group (p<0.01) at the end of 3 month. Appositional closure was relieved in 75% eyes in iridotomy group and 88% eyes in iridotomy plus iridoplasty group. No change was observed in the extent of PAS after the laser treatment in any group. Increased pigmentation in angle was observed in 26% cases in iridotomy plus iridoplasty group as compared to only 5% cases in iridotomy group.

laser peripheral iridotomy plus iridoplasty leads to better control of intraocular pressure as compared to laser peripheral iridotomy alone in management of primary angle closure. Iridoplasty relieves irido trabecular contact but has no influences on the extent of peripheral anterior synechiae.