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Rethinking Prophylactic Laser Peripheral Iridotomy in Primary Angle-Closure Suspects: A Review
Theodoros Filippopoulos1, John Danias2, Efthymios Karmiris3
1Athens Vision Eye Institute, Athens, Greece.
Ophthalmology. Glaucoma
|June 15, 2023
Summary
Recent trials challenge laser peripheral iridotomy (LPI) for primary angle-closure suspects (PACS). Findings suggest clinical practice may need adjustment, considering patient characteristics and potential progression risks in real-world settings.
Area of Science:
- Ophthalmology
- Glaucoma Research
- Clinical Trials
Background:
- Primary angle-closure suspects (PACS) traditionally receive laser peripheral iridotomy (LPI).
- Recent randomized clinical trials (RCTs) have questioned the universal application of LPI for PACS.
- This review synthesizes evidence to re-evaluate current management recommendations.
Conclusions:
- The ZAP-Trial and ANA-LIS provide crucial data for PACS management.
- Physicians should consider additional patient-specific parameters beyond RCT criteria.
- PACS patients at tertiary centers may have advanced ocular biometrics and a higher risk of progression.
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