A comparison of neodymium: YAG and argon laser iridotomies

A prospective short-term clinical study evaluated argon and Q-switched neodymium:YAG laser iridotomies in 40 eyes of 20 patients with primary chronic angle-closure glaucoma. All patients had bilateral iridotomies with one eye randomly assigned to argon laser and the fellow eye to neodymium:YAG laser therapy. In all eyes a patent iridotomy was created in one treatment session. A mean of 12 +/- 11 and 0.033 +/- 0.025 J were needed for iridotomy formation in argon and neodymium:YAG treated eyes respectively. No neodymium:YAG and six (30%) argon iridotomies had marked closure requiring retreatment. Immediate postoperative intraocular pressure elevation greater than 10 mmHg was seen in seven (35%) argon and six (30%) neodymium:YAG-treated eyes. Nine (45%) eyes treated with the neodymium:YAG laser had bleeding from the iridotomy site. No acute lens damage was found in the neodymium:YAG eyes while seven (35%) lenses in the argon group had focal opacities. Seven (35%) neodymium:YAG and five (25%) argon treated eyes had focal nonprogressive corneal opacities above the iridotomy site. Specular microscopy showed a significant central corneal endothelial loss in argon laser treated eyes. No eyes had detectable retinal damage.