·AIM: To obtain widening of a potentially occludable angle, in according to Kanski’s indications, through preventive Nd:Yag laser iridotomy. The observational study was performed by using gonioscopy for the sele...·AIM: To obtain widening of a potentially occludable angle, in according to Kanski’s indications, through preventive Nd:Yag laser iridotomy. The observational study was performed by using gonioscopy for the selection and follow-up of 1165 treated eyes and exploiting Shaffer-Etienne gonioscopic classification as a quality/quantity test of the angle recession.·METHODS: Between September 2000 and July 2012,586 patients were selected at the Outpatients’ Ophthalmological Clinic of the Policlinico Umberto I of Rome in order to undergo Nd: Yag laser iridotomy. A Goldmann type contact lens, Q-switched mode, 2-3defocus, and 7-9 m J intensity with 2-3 impulse discharges were used for surgery.·RESULTS: From as early as the first week, a whole360° angle widening were evident in the patients, thus showing the success of Nd:Yag laser iridotomy in solving relative pupil block. The angle remained narrow by 270° in 14 eyes only, despite repetitions of further treatment with laser iridotomy in a different part of the iris, twice in 10 eyes and three times in 4 eyes.·CONCLUSION: Nd:Yag laser iridotomy revealed itself as being a safe and effective treatment in widening those critical Shaffer-Etienne grade 1 and 2 potentially occludable angles.展开更多
AIM:To report the progression rate(PR)to primary angle closure(PAC)following laser peripheral iridotomy(LPI)in PAC suspects(PACS).METHODS:Prospective,randomized controlled interventional clinical trial conducted at th...AIM:To report the progression rate(PR)to primary angle closure(PAC)following laser peripheral iridotomy(LPI)in PAC suspects(PACS).METHODS:Prospective,randomized controlled interventional clinical trial conducted at the Handan Eye Hospital,China.Totally 134 bilateral PACS,defined as non-visibility of the posterior trabecular meshwork for≥180 degrees on gonioscopy were randomly assigned to undergo LPI in one eye.Gonioscopy and Goldmann applanation tonometry were performed prior to,on day 7 and 12 mo post LPI.RESULTS:Eighty of 134 patients(59.7%)could be followed up at one year.The mean intraocular pressure(IOP)in treated eyes was 15.9±2.6 mm Hg at baseline,15.4±3.0 mm Hg on day 7;16.5±2.9 mm Hg at one month,and 15.5±2.9 mm Hg at 12 mo;the IOP in untreated eyes was similar(P=0.834).One or more quadrants of the angle opened in 93.7%of the LPI treated eyes,but 67.0%(53/79)remained closed in two or more quadrants.The PR to PAC in untreated eyes was 3.75%and one developed acute angleclosure glaucoma(AACG);the PR to PAC in treated eyes was 2.5%and none had developed peripheral anterior synechia(PAS)or AACG.CONCLUSION:LPI can open some of the occludable angle in the majority of eyes with PACS,but 67%continue to have non-visibility of the trabecular meshwork for over 180 degrees.展开更多
文摘·AIM: To obtain widening of a potentially occludable angle, in according to Kanski’s indications, through preventive Nd:Yag laser iridotomy. The observational study was performed by using gonioscopy for the selection and follow-up of 1165 treated eyes and exploiting Shaffer-Etienne gonioscopic classification as a quality/quantity test of the angle recession.·METHODS: Between September 2000 and July 2012,586 patients were selected at the Outpatients’ Ophthalmological Clinic of the Policlinico Umberto I of Rome in order to undergo Nd: Yag laser iridotomy. A Goldmann type contact lens, Q-switched mode, 2-3defocus, and 7-9 m J intensity with 2-3 impulse discharges were used for surgery.·RESULTS: From as early as the first week, a whole360° angle widening were evident in the patients, thus showing the success of Nd:Yag laser iridotomy in solving relative pupil block. The angle remained narrow by 270° in 14 eyes only, despite repetitions of further treatment with laser iridotomy in a different part of the iris, twice in 10 eyes and three times in 4 eyes.·CONCLUSION: Nd:Yag laser iridotomy revealed itself as being a safe and effective treatment in widening those critical Shaffer-Etienne grade 1 and 2 potentially occludable angles.
基金Supported in part by the Ministry of Science and Technology of the National“Eleventh Five-Year”Science and Technology Program in China(No.2007BAI18B08)Beijijng Municipal Science and Technology Commission,Capital Characteristic Clinic Project(No.Z171100001017040)。
文摘AIM:To report the progression rate(PR)to primary angle closure(PAC)following laser peripheral iridotomy(LPI)in PAC suspects(PACS).METHODS:Prospective,randomized controlled interventional clinical trial conducted at the Handan Eye Hospital,China.Totally 134 bilateral PACS,defined as non-visibility of the posterior trabecular meshwork for≥180 degrees on gonioscopy were randomly assigned to undergo LPI in one eye.Gonioscopy and Goldmann applanation tonometry were performed prior to,on day 7 and 12 mo post LPI.RESULTS:Eighty of 134 patients(59.7%)could be followed up at one year.The mean intraocular pressure(IOP)in treated eyes was 15.9±2.6 mm Hg at baseline,15.4±3.0 mm Hg on day 7;16.5±2.9 mm Hg at one month,and 15.5±2.9 mm Hg at 12 mo;the IOP in untreated eyes was similar(P=0.834).One or more quadrants of the angle opened in 93.7%of the LPI treated eyes,but 67.0%(53/79)remained closed in two or more quadrants.The PR to PAC in untreated eyes was 3.75%and one developed acute angleclosure glaucoma(AACG);the PR to PAC in treated eyes was 2.5%and none had developed peripheral anterior synechia(PAS)or AACG.CONCLUSION:LPI can open some of the occludable angle in the majority of eyes with PACS,but 67%continue to have non-visibility of the trabecular meshwork for over 180 degrees.
