[Long-term results of Nd-YAG laser iridotomy and indications deriving from it]

Of 132 patients who had undergone Nd-YAG laser iridotomy, 70 were randomly selected for follow-up examinations. Nd-YAG laser iridotomies were subsequently performed on 124 eyes (of these 70 patients), 12 for acute angle-closure glaucoma, 19 fellow eyes of those which had angle-closure glaucoma, 70 for chronic angle-closure glaucoma, and 23 eyes with increasingly narrow chamber angle under miotic therapy. The follow-up period ranged from 1 to 25 months (median = 9 months). Eighty-seven percent of the iridotomies remained visibly open. Of 12 acute glaucomas, 10 were successfully treated, whereas only 2 required a basal iridectomy. In the large group of 106 eyes with a "narrow angle condition," a significant pressure reduction from 20.9 +/- 5.8 to 16.7 +/- 3.4 mm Hg and a significant enlargement of the chamber angle resulted. Since fistulizing procedures involve a risk of malignant glaucoma, Nd-YAG laser iridotomy, which this investigation showed to be risk-free, is the initial procedure of choice in narrow-angle conditions, especially subacute and chronic angle-closure glaucoma, in order to alleviate the angle-closure component in such angle-closure situations, to diagnose its contribution to peak IOP, and to facilitate argon laser trabeculoplasty when needed.