Efficacy of Laser Iridotomy in Primary Angle Closure Suspects and Primary Angle Closure Glaucoma

Abstract

Addressing the issue of a closed angle of the anterior chamber plays a key role in preventing the development of angleclosure glaucoma.The purpose: to compare the efficacy of Laser Peripheral Iridotomy (LPI) at the stage of primary angle closure suspects (PACs) with LPI carried out at the initial stage of primary angle-closure glaucoma (PACG).Materials and methods. A clinical case of a primary angle closed disease (PACD) in a patient with PACs after LPI in the right eye and with PACG after LPI, selective laser trabeculoplasty (SLT) and phacoemulsification with intraocular lens implantation in the left eye is presented. A detailed examination was performed in dynamics, including methods of visualization of the anterior and posterior segments of the eye.Results. After 2.5 years, the anterior chamber angle in the right eye retained an expanded profile after LPI (up to 30°), no signs of PACG development were recorded. On the left eye, the anterior chamber angle remained closed (9°) with an IOP of 24 mm Hg at the maximum hypotensive therapy with eye drops. Despite the absence of progression of glaucomatous optic neuropathy in both eyes, the risk of the transition from the initial stage to the moderate and advanced stage of PACG in the left eye still remains due to the presence of goniosynechia and possible fluctuations of intraocular pressure.Conclusion. LPI is more effective at the stage of PACs and its implementation is advisable in order to prevent the development of PACG.