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N. Ungaro, C. Sangermani, M. Vecchi, L. Cimino, M. Tardini, S.A. Gandolfi; Yag Laser Iridotomy in Pigment Dispersion Syndrome: 10 Years Later . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4293.
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Purpose: to determine (a) the 10-year conversion rate from pigment dispersion syndrome (PDS) to pigmentary glaucoma (PG) and (b) the possible protective effect of Yag-laser iridotomy Methods: 21 patients with high-risk PDS in both eyes (i.e. patients with a positive epinephrine test and a concave irirs root, on gonioscopy) were assigned to Yag – laser iridotomy in one eye (randomly selected) and no treatment in the fellow eye. Concurrently, 35 patients with either unilateral (n = 22) or bilateral (n= 13) low-risk PDS (i.e. patients with a negative epinephrine test and either a concave or a non-concave iris root on gonioscopy) were followed up. The diagnosis of PDS was made according to (a) 360° pigmented TM, (b) mid-peripheral slit-like defects in iris stroma, (c) IOP < 18 mmHg on repeated readings, and (d) normal optic disk and visual field (Octopus, G1 program). Conversion to PG was arbitrarily established when a > 5 mmHg IOP (average of the two highest values of the diurnal phasing, 6 readings, from 8 a.m. to 6 p.m.) increase was detected during the 10 year- follow up Results: At the end of the 10-year follow up, 16 patients (32 eyes) in the high risk group and 30 patients (40 eyes) in the low-risk group were still in the study. 5 patients (10 eyes) in the high-risk group and 5 patients (8 eyes) in the low-risk group were lost through follow up. Among the high risk group, 62% of the original cohort of iridotomy-treated eyes and 4.7% of the untreated eyes had not converted to PG. The protective effect of iridotomy was statistically significant (Fisher exact test, p < 0.0011, alpha probability = 5%). Among the low-risk group, less than 10% of the original cohort had shown conversion to PG. Conclusions: Yag laser iridotomy offered a 10-year protective effect in eyes showing a high risk pigment dispersion. The 10 year conversion rate to PG proved low in low risk PDS eyes.
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