Long-term success of argon laser peripheral iridoplasty in the management of plateau iris syndrome

Abstract

Objective To document the long-term effect of argon laser peripheral iridoplasty (ALPI) in eyes with plateau iris syndrome. Design Retrospective, noncomparative, interventional case series. Setting New York Eye and Ear Infirmary. Methods The charts of all patients with plateau iris syndrome treated with ALPI from 1982 to 1991 and subsequently followed for 6 or more years were retrospectively reviewed. Patients with lens-related mechanisms contributing to angle closure (e.g., phacomorphic or malignant glaucoma) were excluded. Main outcome measures Necessity for repeat ALPI and/or any additional means of intervention. Results A total of 26 ALPI procedures were performed in 23 eyes of 14 patients (4 men, 10 women). The mean age was 61±8.7 years. The mean follow-up was 78.9±8.0 months (range, 72–188 months). The angle in 20 of 23 (87.0%) eyes remained open throughout the entire follow-up period after only 1 treatment with ALPI. In 3 eyes, there was gradual reclosure of the angle 5 to 9 years after initial ALPI, but they were readily reopened and maintained open by a single repeat treatment. No filtration surgery was necessary in any eye during follow-up. Conclusions ALPI is highly effective in eliminating residual appositional closure after laser iridotomy caused by plateau iris syndrome. The effect is maintained for years, although a small proportion of patients might require retreatment.