June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Intraocular Pressure Spikes following Sequential Laser Peripheral Iridotomy for Angle Closure
Author Affiliations & Notes
  • Jamie Ng
    Singapore National Eye Centre and Singapore Eye Research Institute, Singapore, Singapore
    National University Health Systems, Singapore, Singapore
  • Tian Loon Lee
    Singapore National Eye Centre and Singapore Eye Research Institute, Singapore, Singapore
  • Monisha Nongpiur
    Singapore National Eye Centre and Singapore Eye Research Institute, Singapore, Singapore
    Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
  • Wai-Jia Tan
    National University Health Systems, Singapore, Singapore
  • Tin Aung
    Singapore National Eye Centre and Singapore Eye Research Institute, Singapore, Singapore
    National University Health Systems, Singapore, Singapore
  • Shamira Perera
    Singapore National Eye Centre and Singapore Eye Research Institute, Singapore, Singapore
  • Footnotes
    Commercial Relationships Jamie Ng, None; Tian Loon Lee, None; Monisha Nongpiur, None; Wai-Jia Tan, None; Tin Aung, Alcon (R), Alcon (C), Alcon (F), Allergan (R), Allergan (C), Carl Zeiss Meditec (F), Carl Zeiss Meditec (R), Ellex (F), Ellex (R), Santen (R); Shamira Perera, Carl Zeiss Meditec (R), Allergan (R), Pfizer (R)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 1855. doi:
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    • Get Citation

      Jamie Ng, Tian Loon Lee, Monisha Nongpiur, Wai-Jia Tan, Tin Aung, Shamira Perera; Intraocular Pressure Spikes following Sequential Laser Peripheral Iridotomy for Angle Closure. Invest. Ophthalmol. Vis. Sci. 2013;54(15):1855.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To determine the incidence of intraocular pressure (IOP) spikes within the first 30 minutes after sequential argon-Nd:YAG laser peripheral iridotomy (LPI) in patients with angle closure and to explore risk factors for their occurrence.

Methods: 428 consecutive eyes of 298 patients who had undergone LPI at the Singapore National Eye Centre (SNEC) between June 2011 and August 2011 were reviewed retrospectively. There were 238 primary angle closure suspect (PACS) eyes, 85 primary angle closure (PAC) eyes, 92 primary angle closure glaucoma (PACG) eyes and 13 acute primary angle closure (APAC) eyes. The pre and post-LPI IOP, gonioscopic findings, medications, laser parameters and the need for acute IOP-lowering treatment were recorded.

Results: The proportion of patients with a post-LPI IOP elevation ≥ 8mmHg was 10.7% (n=46) and those with a significant IOP spike of ≥ 30mmHg was 31 (7.2%). There were no significant differences between those with or without a post-LPI IOP elevation ≥ 8mmHg and those with or without a post-LPI IOP of ≥ 30mmHg, in terms of age, gender, race, total laser energy utilised and seniority of the physician performing the procedure. Patients who experienced IOP spike ≥ 8mmHg were on fewer pre-LPI medications (p=0.009). On logistic regression, patients with APAC had a significantly higher probability of an IOP spike (p=003).

Conclusions: There was a low incidence of post-LPI IOP spikes after sequential LPI. The primary diagnosis of APAC was a risk factor, and using pre-procedure ocular hypotensives can potentially reduce their occurrence.

Keywords: 568 intraocular pressure • 578 laser  
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