Results of iridectomy in narrow-angle and open-angle glaucoma. A retrospective study

Abstract

Between 1970 and 1975 166 iridectomies were performed in cases of primary glaucoma. In the retrospective study reported here the authors analyzed the results with regard to the regulation of intraocular pressure (IOP) and loss of function. Follow-up examinations were performed (1) between 6 weeks and 6 months, (2) 12 months, (3) 1.5 to 2.5 years and (4) 3 to 4 years after surgery in patients whose IOP was not adequately regulated. Hypotonia was rare. Of the eyes with acute narrow-angle glaucoma with an open iridocorneal angle by definition, which underwent surgery for the first time, 30% had an IOP of more than 21 mm Hg with or without additional tension-lowering medication (20% between 22 and 24 mm Hg, 10% over 24 mm Hg). The results for eyes operated on for the second time were better because of the prophylactic iridectomies in this group. In one-third of the cases the iridocorneal angle was occluded; in two-thirds an open angle was found. An analysis revealed that regulation was better when the previous tension level had been high, while lower tension levels, of between 20 and 35 mm Hg, often remained elevated after surgery. Out of the total number of eyes operated on for the first time (narrow-angle and open-angle glaucoma) IOP was regulated by iridectomy alone in 54% after 1 year and in 33% after 2 years. With regard to the iridocorneal angle of these 33%, it was found that 50% of the cases of narrow-angle glaucoma were regulated without further medication, but only 20% of the open-angle cases.(ABSTRACT TRUNCATED AT 250 WORDS)