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M. D. Aquino, G. Dizon, J. L. See, P. T. Chew; Sequential Laser Iridotomy Using Argon and Q-Switched 532-Nm Frequency Doubled Neodymium (Fd-Nd) Yag Lasers: A Pilot Study. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1230.
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The aim of this study is to evaluate the safety and efficacy of using argon laser and Q-switched 532-nm frequency doubled neodymium (fd-Nd) YAG laser in sequential laser iridotomy (LI) of angle closure eyes.
This was a prospective non-randomized case series of 10 Asian patients. Ten eyes with occludable angles by gonioscopy and anterior segment optical coherence tomography were included in the study. After baseline ophthalmologic examination and specular microscopy, sequential LI was performed using argon laser followed by Q-switched 532-nm frequency doubled neodymium (fd-Nd) yag laser using 400 - 500µm spot size, 2.6mJ power and 3 nanoseconds duration. Follow-up evaluation was performed at 1 week, 1 month, 3 months and 6 months intervals.
One primary angle closure glaucoma (PACG), 6 primary angle closure (PAC) and 3 primary angle closure suspects were treated. There were 8 females and 2 males with mean age of 61.5 years. Average laser settings used were as follows: Argon 1.0W, 100ms, 21 shots; Q-switched 532-nm frequency doubled neodymium (fd-Nd) YAG laser 2.66mJ power, 3nanoseconds, 4.3 shots. One out of 10 complained of moderate pain during the procedure. No intraocular pressure (IOP) spike was noted 1 hour post laser. IOP was stable from pre-laser of 15.36 mmHg to mean of 13.83 mmHg six months after treatment. Iridotomy site was patent in all patients during entire follow up period and LI size increased from 280µm to 400µm average on the 6th month. Only 2 patients had mild inflammation lasting for 1 week. There was no deterioration in visual acuity although 3 patients had mild nuclear sclerotic change by LOCS3 during the final follow up. No remarkable change in endothelial cell count was observed.
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