The forecast of long-term efficacy of Nd: YAG laser peripheral iridectomy

Abstract

Objective To study the prediction of the long-term efficacy of the Nd:YAG laser peripheral iridectomy for primary angle-closure glaucoma.Methods 204 eyes of 156 cases with primary acute angle-closure glaucoma including preclinical stage,remission stage or early primary chronic angle-closure glaucoma received Nd:YAG laser peripheral iridectomy treatment,and were followed up for 1 to 5 years.The observed data included the visual aeuity before and after operation,intraocular pressure,the central and peripheral anterior chamber depth,angle forms and the cup disc ratio,and in some patients the darkroom test and visual field were retrospectively analysed.Results Of 204 eyes received Nd:YAG laser peripheral iridectomy,30 eyes (14.7％) developed new anterior chamber adhesion and closure or the original adhesion expanded,and complicated with glaucoma visual function damage at 1 ～ 5 years after laser treatment.These failed cases had common morphologic features:shallow anterior chamber,forward ended iris root,peripheral iris synechia before the iridectomy,or no obvious deepening of anterior chamber or broadening of anterior chamber angle after iridectomy.Conclusion The correct evaluation of preoperative morphological structure of anterior chamber angle and observation of changes of postoperative peripheral anterior chamber depth after iridectomy are two important forecast factors for postoperative long-term curative effect. Key words: Glaucoma, closed-angle, primary; Iridectomy, peripheral,laser; Prediction, efficacy