June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Are There Clinically-Significant Intraocular Pressure Changes in the Fellow Untreated Eye Following Laser Peripheral Iridotomy of the Diseased Eye?
Author Affiliations & Notes
  • Abdul Rhman Hassan
    Tanta University Faculty of Medicine, Tanta, Egypt
  • Ramadan Abdelmoez Farahat
    Kafrelsheikh University, Kafr el-Sheikh, Egypt
  • Kawthar Djebabria
    Centre Hospitalier Universitaire Annaba, Annaba, Algeria
  • Mohamed Ebrahim
    Cairo University, Giza, Giza, Egypt
  • Menna M. Aboelkhier
    Suez Canal University, Ismailia, Ismailia, Egypt
  • Amro El-Sakka
    Suez Canal University, Ismailia, Ismailia, Egypt
  • Miral Farid Shokry Ataya
    Ain Shams University, Cairo, Cairo, Egypt
  • Mohamed Elsady
    Zagazig University, Zagazig, Egypt
  • Basel Abdelazeem
    McLaren Health Care Corp, Flint, Michigan, United States
  • Hashem Abu Serhan
    Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
  • Basant Katamesh
    Tanta University Faculty of Medicine, Tanta, Egypt
  • Abdelaziz Abdelaal
    Harvard Medical School, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Abdul Rhman Hassan None; Ramadan Abdelmoez Farahat None; Kawthar Djebabria None; Mohamed Ebrahim None; Menna M. Aboelkhier None; Amro El-Sakka None; Miral Farid Shokry Ataya None; Mohamed Elsady None; Basel Abdelazeem None; Hashem Abu Serhan None; Basant Katamesh None; Abdelaziz Abdelaal None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 4898. doi:
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      Abdul Rhman Hassan, Ramadan Abdelmoez Farahat, Kawthar Djebabria, Mohamed Ebrahim, Menna M. Aboelkhier, Amro El-Sakka, Miral Farid Shokry Ataya, Mohamed Elsady, Basel Abdelazeem, Hashem Abu Serhan, Basant Katamesh, Abdelaziz Abdelaal; Are There Clinically-Significant Intraocular Pressure Changes in the Fellow Untreated Eye Following Laser Peripheral Iridotomy of the Diseased Eye?. Invest. Ophthalmol. Vis. Sci. 2023;64(8):4898.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : There are no guidelines regarding the monitoring of the intraocular pressure (IOP) of untreated eyes following glaucoma surgery. This meta-analysis studies the IOP change in fellow untreated eyes after laser peripheral iridotomy (LPI).

Methods : Nine randomized controlled trials (3146 patients, 6292 eyes) were included following a systematic search of 9 databases [protocol: CRD42022364618]. The primary outcome included pre- vs. post-operative IOP change. A clinically significant difference was defined as ≤ 2 mmHg change. Secondary outcomes included the prevalence of composite outcome (acute angle closure glaucoma (AACG), acute angle closure (AAC), or both) or peripheral anterior synechia (PAS), as well as the change in angle width and limbal anterior chamber depth (ACD). The revised Cochrane tool was used to assess the risk of bias (ROB). Analyses were conducted using STATA. The crude mean difference (MD) was calculated for continuous outcomes, and the pooled effect size (ES) was used to calculate the prevalence. The assessment of publication bias was not applicable, and the sensitivity analysis revealed no significant changes in reported estimates.

Results : All trials were of low ROB. No statistically nor clinically significant IOP changes were noted [6 studies/3048 eyes, MD=-0.17; 95%CI: -1.05: 0.70; I2=96.58%]. This change remained insignificant throughout follow-up [6 - 54 months]. IOP rise by at least 5, 8, or 10 mmHg occurred in 5% [3 studies/3390 eyes, 95%CI: 4-6%; I2=0%], 1% [2 studies/3246 eyes, 95%CI: 0-1%; I2=0%], and 0% [2 studies/3246 eyes] of eyes, respectively. The composite outcome rarely occurred [2 studies/2738 eyes, ES=5%; 95%CI: 4-6%; I2=0%], with no significant change according to the length of follow-up. Similarly, PAS occurred in only 4% of eyes [2 studies/2738 eyes, 95%CI: 3-5%; I2=0%]. No significant change was noted in angle width [2 studies/2738 eyes, MD=-0.25; 95%CI: -3.52: 3.01; I2=99.53%] and limbal ACD [MD=-2.31; 95%CI: -16.95; 12.33; I2=99.52%].

Conclusions : The occurrence of serious complications, like angle-closure, angle-closure glaucoma, or drastic rise in IOP does not surpass the rare event assumption. Our findings, of moderate certainty, do not support the cautionary screening of fellow untreated eyes following LPI.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

 

IOP change in fellow untreated eyes following LPI

IOP change in fellow untreated eyes following LPI

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