April 2010
Volume 51, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2010
Immediate Change in Intraocular Pressure after Laser Iridotomy in Primary Angle-closure Suspects: the Zhongshan Angle-closure Prevention Study
Y. Jiang; D. S. Chang; P. J. Foster; M. He; S. Huang; D. S. Friedman
Author Affiliations & Notes
  • Y. Jiang
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangzhou, China
  • D. S. Chang
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangzhou, China
    Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
  • P. J. Foster
    National Biomedical Research Centre for Ophthalmology, UCL Institute of Ophthalmology and Moorfields Eye Hospital, London, United Kingdom
  • M. He
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangzhou, China
    National Biomedical Research Centre for Ophthalmology, UCL Institute of Ophthalmology and Moorfields Eye Hospital, London, United Kingdom
  • S. Huang
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangzhou, China
  • D. S. Friedman
    Ophthalmology, Johns Hopkins Wilmer Eye Inst, Baltimore, Maryland
    Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
  • Footnotes
    Commercial Relationships  Y. Jiang, None; D.S. Chang, None; P.J. Foster, None; M. He, None; S. Huang, None; D.S. Friedman, None.
  • Footnotes
    Support  Fight for Sight Foundation, UK; Sun Yat-sen Clinical Research 5010 Project, China
Investigative Ophthalmology & Visual Science April 2010, Vol.51, 6404. doi:
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      Y. Jiang, D. S. Chang, P. J. Foster, M. He, S. Huang, D. S. Friedman; Immediate Change in Intraocular Pressure after Laser Iridotomy in Primary Angle-closure Suspects: the Zhongshan Angle-closure Prevention Study. Invest. Ophthalmol. Vis. Sci. 2010;51(13):6404.

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Abstract

Purpose: : To determine the immediate changes of intraocular pressure after laser peripheral iridotomy (LPI) in primary angle closure suspect (PACS) cases in a randomized clinical trial.

Methods: : Subjects identified as primary angle-closure suspects aged 50-70 years were treated with LPI using YAG only procedure in a randomly selected eye whereas the fellow eyes served as controls. Intraocular pressure (IOP) was measured using Goldmann Applanation Tonometer before and one hour after LPI. Baseline examinations before LPI included refraction, gonioscopy, ultrasound-A scan, van Herick limbal anterior chamber depth scoring, fundus photography, scanning peripheral anterior chamber depth analyzer imaging and dark room prone provocative testing. Total energy used and complications during the procedures were recorded.

Results: : A total of 710 subjects participated in this study. The average IOP increased from 15.55±2.73 mmHg before treatment to 17.47± 4.73 mmHg one hour after treatment in the treated eyes, as compared to 15.57±2.67 mmHg to 15.14± 2.63 mmHg in the untreated eyes. The proportion of eyes with an IOP spike (defined as 8 mmHg or greater elevation) was 10% in the treated eyes and only 0.42% in the untreated eyes. The IOP spike was associated with more laser energy used (0.205±0.185J vs. 0.146±0.118J, P<0.001) and bleeding or corneal burn during LPI procedures (42.26% vs. 30.88%, P=0.051). Multivariable linear regression showed that IOP increased 0.45 mmHg with every 0.1J increase in total laser energy used and increased 2.67 mmHg with every 1 mm decrease in central anterior chamber depth (ACD) as compared to pre-LPI mean IOP.

Conclusions: : IOP spike after LPI is associated with total laser energy used, bleeding during the procedure and shallower anterior chamber.

Clinical Trial: : http://www.controlled-trials.com/ISRCTN45213099

Keywords: intraocular pressure • laser • anterior chamber 
© 2010, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Permission to republish any abstract or part of an abstract in any form must be obtained in writing from the ARVO Office prior to publication.
Copyright © 2025 Association for Research in Vision and Ophthalmology.
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