Neodymium: YAG laser iridolenticular synechiolysis in uveitis

Fifteen patients with "bound down" pupil or ring synechiae associated with chronic granulomatous uveitis in whom dilatation could not be obtained pharmacologically underwent iris-lens synechiolysis using relatively low energies from a Q-switched Nd:YAG laser. Pupil size increased significantly in all of the treated eyes; visual acuity improved in 40%. Postlaser elevated intraocular pressure developed in a significant number, but there were no serious long-term complications associated with the procedure. Although acuity improved in less than half of the patients, because this laser treatment is relatively safe and offers some possibility of visual improvement, we recommend it for routine use, but only if performed by an experienced laser microsurgeon.