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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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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.
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.
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.
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.
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