April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Bilateral Same-Day Laser Peripheral Iridotomy in a Community-Based Glaucoma-Screening Project in Philadelphia
Author Affiliations & Notes
  • Michael Waisbourd
    Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA
  • Radha Delvadia
    Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA
  • Harjeet Sembhi
    Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA
  • Lisa A Hark
    Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA
  • L Jay Katz
    Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA
  • Footnotes
    Commercial Relationships Michael Waisbourd, None; Radha Delvadia, None; Harjeet Sembhi, None; Lisa Hark, None; L Jay Katz, Allergan, Aerie Pharm., Merck, Bausch & Lomb (F), Allergan, Alcon, Glaukos, Aerie Pharm., Bausch & Lomb, Sucampo, Inotek, Sensimed AG (C), Allergan, Alcon, Merck, Lumenis (R), Glaukos, Mati Therapeutics (I)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 6153. doi:
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      Michael Waisbourd, Radha Delvadia, Harjeet Sembhi, Lisa A Hark, L Jay Katz; Bilateral Same-Day Laser Peripheral Iridotomy in a Community-Based Glaucoma-Screening Project in Philadelphia. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6153.

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

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Abstract

Purpose: The project "Improving Access to Eye Care Among High-Risk Persons for Glaucoma in Philadelphia" is a community-based project that aims to improve detection, management, treatment, and follow-up care of individuals at high risk for glaucoma in senior centers and community centers in Philadelphia. This novel project utilized a strategy of performing laser peripheral iridotomy (LPI) for high-risk persons with anatomically narrow angle (ANA), where 2 eyes received laser therapy on the same day. The objective of this study is to report the safety and efficacy of bilateral, same-day LPI in patients with ANA.

Methods: The Wills Eye Glaucoma Research Center retrospectively reviewed the records of patients who were examined in a community-based, glaucoma-screening project between January 1, 2013 and July 31, 2013. Patients who underwent bilateral same-day LPI in community settings were included. Visual acuity, intraocular pressure (IOP), angle grading, post-operative complication and recommendation for post-operative IOP lowering medications were recorded before and after each treatment.

Results: Among the 723 patients examined, 34 patients (4.7%) underwent bilateral same-day LPI due to ANA. Seven patients (21%) had IOP spikes >5mmHg following treatment and were given IOP lowering medications for a period of 2 to 3 weeks. IOP spikes of >10mmHg occurred in 4 patients (12%). IOP returned to normal in all but one patient who was diagnosed with chronic angle-closure glaucoma and continued the use of ophthalmic medications. Seven patients (21%) had repeat LPI treatment. All patients successfully tolerated LPI treatment without serious complications.

Conclusions: Performing bilateral LPI on the same day to treat ANA was found to be a safe procedure in a large community-based, glaucoma-screening project. Applying this treatment strategy may be considered in similar settings, where patients’ access to eye-care is limited.

Keywords: 578 laser • 466 clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • 460 clinical (human) or epidemiologic studies: health care delivery/economics/manpower  
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