Intraocular pressure spikes after a sequential laser peripheral iridotomy for angle closure

Area of Science:

• Ophthalmology
• Laser Surgery
• Glaucoma Research

Background:

• Angle closure glaucoma poses a significant risk to vision.
• Laser peripheral iridotomy (LPI) is a common procedure to manage angle closure.
• Monitoring intraocular pressure (IOP) post-LPI is crucial for patient outcomes.

Purpose of the Study:

• To determine the incidence of IOP spikes within 30 minutes after sequential LPI.
• To identify risk factors associated with post-LPI IOP elevations.
• To evaluate the potential of preprocedure medications in mitigating IOP spikes.

Main Methods:

• Retrospective review of 428 eyes from 298 patients undergoing LPI.
• Analysis of pre- and post-LPI IOP, gonioscopy, medications, and laser parameters.
• Inclusion of various angle closure subtypes: suspect, primary, and acute primary angle closure (APAC).

Main Results:

• A 10.7% incidence of post-LPI IOP elevation ≥8 mm Hg was observed.
• Acute primary angle closure (APAC) was identified as a significant risk factor for IOP spikes.
• Patients with IOP spikes used fewer pre-LPI medications, suggesting a potential protective effect.

Conclusions:

• The incidence of post-LPI IOP elevation ≥8 mm Hg is 10.7%.
• Primary diagnosis of APAC is a risk factor for IOP spikes.
• Preprocedure ocular hypotensives may reduce the occurrence of post-LPI IOP elevation.