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Charles Dillon McCanna, Frank Cao, Inci Dersu; Outcomes of Resident-Performed Laser Peripheral Iridotomy on African-American Patients with Anatomical Narrow Angles. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4977.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the efficacy, complications and associated factors of laser peripheral iridotomy (LPI) procedures performed by ophthalmology residents on African-American patients with anatomical narrow angles.
Retrospective chart analysis was performed on African American patients with anatomical narrow angles who underwent either Neodymium-doped Yttrium Aluminium Garnet (ND:YAG) or combination argon-Nd:YAG LPI from August 2010 to January 2015 at Kings County Hospital in Brooklyn, NY. Race, refractive error, type of laser(s), laser power, location of iridotomy, patency of iridotomy and complications of patients undergoing the procedure were collected. Intraocular pressure (IOP) was compared between the pre-procedure and subsequent clinic visits.
After excluding patients with no follow-up or missing data, 57 eyes from 34 patients with diagnosis of anatomical narrow angles were included in the study. All patients identified as African American. Average age of patients was 63 and 79% of patients were female. A total of 65 LPI procedures were performed on the 57 eyes. No complications were seen in 63 of the 65 procedures. One corneal burn and one case of microhyphema were reported. Average refractive error was +1.25. Second year ophthalmology residents performed 89% of LPI procedures. Thirty-nine eyes had combination argon-Nd:YAG LPI procedures while 26 eyes had Nd:YAG-only LPI procedures. There was a statistically significant difference between YAG energy used between Nd:YAG procedures (mean 58.3 mJ) and argon-Nd:YAG procedures (mean 131.5 mJ) (p<0.01). Of the 57 eyes, 52 iridotomies were successfully patent after one procedure. No significant difference was noted between preoperative IOP (15.9±3.6) and postoperative IOP at one week (15.9±3.4) and one year (16.1±2.4). LPIs were performed between ten and two o’clock in 71% of procedures.
Despite variable energy levels necessary to perform laser iridotomy, ophthalmology residents can successfully perform the procedure for narrow anatomic angles with low complication rates on African American patients.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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