Re-elevation Intraocular Pressure after Peripheral Laser Iridotomy in Patients with Closed Angle

1. Sungmin Hyung¹
2. Dukkyu Choi¹
3. Joo Hwa Lee²
4. Kyoo Won Lee³

¹Chungbuk National University Hospital, Chungbuk, Korea
²Sanggye Paik Hospital, Inje University, Seoul, Korea
³Cheil Eye Hospital, Daegu, Korea

Purpose : To investigate the long-term effects of maintenance of intraocular pressure (IOP) after peripheral laser iridotomy (PLI) in patients with closed angle.

Methods : We assessed patients who were received PLI, and divided them into two groups. There were 38 patients (41 eyes) with a history or ocular findings of acute angle closure attack in Group A, and 54 patients (70 eyes) who undergone preventive PLI in Group B. When the IOP was over 18 mmHg, it was thought to be re-elevated. We analyzed the effects of PLI in IOP maintenance by investigating the number of patients who have re-elevated IOP and the duration until the re-elevation.

Results : In Group A, the amounts of IOP elevation after PLI were 0.9, 1.7, 2.5, 2.7, 2.6 mmHg at 6, 12, 24, 36, 48 month. In Group B, 0.1, 0.4, 0.5, 0.4, 0.5 mmHg. The rates of re-elevation at 6 and 48 months after PLI were 27.0% and 51.4% in Group A, 9.0% and 30.4% in Group B (Kaplan-Meier Survival Analysis), and there was significant statistical difference (P=0.02, Log rank test).

Conclusions : We recommend early PLI for prevention of 'attack' of acute angle closure, And patients received PLI should be followed up closely, because there is high risk of re-elevation of IOP within a couple of years, despite well-controlled immediate IOP after PLI.