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Related Experiment Video

Updated: Mar 30, 2026

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Laser peripheral iridotomy for dark-induced angle closure changes: A proof-of-concept study.

N Malek-Chehire1, P Devillier2, V Pierre-Kahn1

  • 1Department of Ophthalmology, Foch Hospital, 40, rue Worth, 92150 Suresnes, France.

Journal Francais D'Ophtalmologie
|March 28, 2026
PubMed
Summary

Laser peripheral iridotomy (LPI) effectively treated dark-induced angle closure (AC) changes (DACC) in phakic eyes. This procedure reduced intraocular pressure and improved retinal nerve fiber layer thickness, suggesting DACC is an early-stage AC.

Keywords:
Angle closureAnterior chamberContact irido-trabéculaireCouche des fibres nerveuses rétiniennesDark-induced angle closureGlaucomaGlaucome par fermeture de l’angleGonioscopieGonioscopyIridotomieIridotomyIridotrabecular contactLaser YAGModifications de l’angle induites par l’obscuritéRetinal nerve fiber layerShaffer angleYAG laser

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Area of Science:

  • Ophthalmology
  • Glaucoma Research
  • Laser Surgery

Background:

  • Dark-induced angle closure (AC) changes (DACC) represent a potential early stage of angle closure.
  • Understanding DACC is crucial for preventing progression to AC glaucoma.

Purpose of the Study:

  • To evaluate the outcomes of laser peripheral iridotomy (LPI) in phakic eyes diagnosed with DACC.
  • To determine if LPI can favorably alter the course of DACC.

Main Methods:

  • Phakic adult outpatients with DACC underwent bilateral YAG laser peripheral iridotomy (LPI).
  • Baseline and 12-month follow-up included intraocular pressure (IOP) measurement, retinal nerve fiber layer (RNFL) thickness assessment, and gonioscopy in the dark.
  • DACC was defined by gonioscopic findings of iridotrabecular contact (ITC) and/or a Shaffer angle ≤20° in the dark.

Main Results:

  • 114 patients (mean age 59.6 years) were included; 92% had normal IOP without glaucoma.
  • At 12 months, mean IOP decreased by 1.7 mmHg (P<0.001), and mean RNFL thickness increased by 0.42 μm (P=0.045).
  • All patients demonstrated immediate anterior chamber deepening post-LPI; 47% had Shaffer angle ≤20° at baseline.

Conclusions:

  • LPI demonstrated favorable outcomes in eyes with DACC, including reduced IOP and improved RNFL thickness.
  • These findings suggest DACC is a clinically relevant entity indicative of early-stage angle closure.
  • LPI may serve as a preventative strategy for angle closure and subsequent glaucoma.