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Early intraocular pressure change after peripheral iridotomy with ultralow fluence pattern scanning laser and Nd:YAG laser in primary angle-closure suspect: Kowloon East Pattern Scanning Laser Study Report No. 3

  • Glaucoma
  • Published:
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Abstract

Purpose

Our purpose was to assess the early intraocular pressure (IOP) changes of ultralow fluence laser iridotomy using pattern scanning laser followed by neodymium:yttrium-aluminum-gamet (Nd:YAG) laser.

Methods

This is a prospective interventional study. Thirty-three eyes of 33 adult Chinese primary angle-closure suspect subjects were recruited for prophylactic laser peripheral iridotomy. Sequential laser peripheral iridotomy was performed using pattern scanning laser followed by Nd:YAG laser. Visual acuity (VA) and IOP were measured before treatment, at 1 h, 1 day, 1 week, 1 month, 3 months and 6 months after laser. Laser energy used and complications were documented. Corneal endothelial cell count was examined at baseline and 6 months. Patency of the iridotomy was assessed at each follow-up visit.

Results

All subjects achieved patent iridotomy in a single session. The mean energy used was 0.335+/−0.088 J for the pattern scanning laser, and 4.767+/−5.780 mJ for the Nd:YAG laser. The total mean energy was 0.339+/−0.089 J. None of the eyes developed a clinically significant IOP spike (≥ 8 mmHg) at 1 h and 1 day after laser use. Only four eyes developed higher IOP at 1 h and all were ≤3 mmHg compared to baseline. The mean IOP was 13.8+/−2.5 mmHg at 1 h and 11.5+/−2.2 mmHg at 1 day, both were significantly lower than baseline (15.8+/−2.1 mmHg) (P < 0.001). Mean VA (logMAR) was similar at 1 h post laser compared to baseline (0.23 vs 0.26). There was also no statistically significant difference in mean VA at other follow-up visits compared to baseline. Peripheral iridotomy closure was encountered in two (6.1%) eyes, one at 1 month and another at 6 months follow-up. There were no complications including hyphema, peripheral anterior synechia formation nor prolonged inflammation throughout the follow-up period. There was no significant loss in corneal endothelial cell counts at 6 months (2255+/−490) compared to baseline (2303+/−386) (P = 0.347).

Conclusions

Sequential LPI using an ultralow fluence pattern scanning laser, followed by a Nd:YAG laser, is safe and efficacious, and produces no IOP spike in dark irides of primary angle-closure suspects. Further studies to investigate its role in the treatment of other angle-closure conditions are warranted.

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References

  1. Quilgey HA (1981) Long-term follow-up of laser iridotomy. Ophthalmology 88(3):218–24

  2. Naveh-Floman N, Blumenthal M (1985) A modified technique for serial use of argon and Nd:YAG lasers in laser iridotomy. Am J Ophthalmol 100(3):485–486

    Article  CAS  PubMed  Google Scholar 

  3. Tomey KF, Traverso CE, Shammas IV (1987) Neodymium-YAG laser iridotomy in the treatment and prevention of angle closure glaucoma. A review of 373 eyes. Arch Ophthalmol 105(4):476–481

    Article  CAS  PubMed  Google Scholar 

  4. Ho T, Fan R (1992) Sequential argon-YAG laser iridotomies in dark irides. Br J Ophthalmol 76(6):329–331

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Jiang Y, Chang DS, Foster PJ et al (2012) Immediate changes in intraocular pressure after laser peripheral iridotomy in primary angle-closure suspects. Ophthalmology 119(2):283–288

    Article  PubMed  Google Scholar 

  6. deSilva DJ, Day AC, Bunce C et al (2012) Randomised trial of sequential pretreatment for Nd:YAG laser iridotomy in dark irides. Br J Ophthalmol 96(2):263–266

    Article  Google Scholar 

  7. Lee TL, Yuxin NJ, Nongpiur ME et al (2014) Intraocular pressure spikes after a sequential laser peripheral iridotomy for angle closure. J Glaucoma 23(9):644–648

    Article  PubMed  Google Scholar 

  8. Muraly P, Limbad P, Srinivasan K, Ramasamy K (2011) Single session of Pascal versus multiple sessions of conventional laser for panretinal photocoagulation in proliferative diabetic retinopathy: a comparative study. Retina 31(7):1359–1365

    Article  PubMed  Google Scholar 

  9. Muqit MM, Marcellino GR, Henson DB et al (2011) Pascal panretinal laser ablation and regression analysis in proliferative diabetic retinopathy: Manchester Pascal study report 4. Eye (Lond) 25(11):1447–1456

    Article  CAS  Google Scholar 

  10. Chappelow AV, Tan K, Waheed NK, Kaiser PK (2012) Panretinal photocoagulation for proliferative diabetic retinopathy: pattern scan laser versus argon laser. Am J Ophthalmol 153(1):137–142

    Article  PubMed  Google Scholar 

  11. Pei-Pei W, Shi-Zhou H, Zhen T et al (2015) Randomised clinical trial evaluating best-corrected visual acuity and central macular thickness after 532-nm subthreshold laser grid photocoagulation treatment in diabetic macular oedema. Eye (Lond) 29(3):313–321

    Article  CAS  Google Scholar 

  12. Mahgoub MM, Macky TA (2016) The effect of laser panretinal photocoagulation on diabetic macular edema using the PASCAL photocoagulator versus the conventional argon laser photocoagulator. Ophthalmologica 235(3):137–140

    Article  CAS  PubMed  Google Scholar 

  13. Seymenoglu RG, Ulusoy MO, Baser EF (2016) Safety and efficacy of panretinal photocoagulation in patients with high-risk proliferative diabetic retinopathy using pattern scan laser versus conventional YAG laser. Kaohsiung J Med Sci 32(1):22–26

    Article  PubMed  Google Scholar 

  14. Chung CY, Cheung JJ, Ng AL, Gangwani RA, Li KK (2017) Pattern scanning laser Panretinal photocoagulation in proliferative diabetic retinopathy: Kowloon east pattern scanning laser study report no. 1. Ophthalmology retina (In Press)

  15. Chung HJ, Park HY, Kim SY (2015) Comparison of laser iridotomy using short duration 532-nm Nd:YAG laser (PASCAL) vs conventional laser in dark irides. Int J Ophthalmol 8(2):288–291

    PubMed  PubMed Central  Google Scholar 

  16. Robin AL, Pollack IP (1984) A comparison of neodymium:YAG and argon laser iridotomies. Ophthalmology 91(9):1011–1016

    Article  CAS  PubMed  Google Scholar 

  17. Drake MV (1987) Neodymium:YAG laser iridotomy. Surv Ophthalmol 32(3):171–177

    Article  CAS  PubMed  Google Scholar 

  18. Goins K, Schmeisser E, Smith T (1990) Argon laser pretreatment in Nd:YAG iridotomy. Ophthalmic Surg 21(7):497–500

    CAS  PubMed  Google Scholar 

  19. Lim L, Seah SK, Lim AS (1996) Comparison of argon laser iridotomy and sequential argon laser and Nd:YAG laser iridotomy in dark irides. Ophthalmic Surg Lasers 27(4):285–288

    CAS  PubMed  Google Scholar 

  20. Nagpal M, Marlecha S, Nagpal K (2010) Comparison of laser photocoagulation for diabetic retinopathy using 532-nm standard laser versus multispot pattern scan laser. Retina 30(3):452–458

    Article  PubMed  Google Scholar 

  21. Lee JY, Ha SY, Paik HJ et al (2014) Morphologic changes in trabecular meshwork after patterned and argon laser trabeculoplasty in cats. Curr Eye Res 39(9):908–916

    Article  PubMed  Google Scholar 

  22. Turati M, Gil-Carrasco F, Morales A et al (2010) Patterned laser trabeculoplasty. Ophthalmic Surg Lasers Imaging 41(5):538–545

    Article  PubMed  Google Scholar 

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Funding

No funding was received for this research.

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Authors and Affiliations

  1. Department of Ophthalmology, United Christian Hospital, 130 Hip Wo Street, Kowloon, Hong Kong

    Jeffrey Chi Wang Chan, Orlando Chia Chieh Chan & Kenneth Kai Wang Li

  2. Department of Ophthalmology, Tseung Kwan O Hospital, Tseung Kwan O, Hong Kong

    Jeffrey Chi Wang Chan & Kenneth Kai Wang Li

  3. Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong

    Bonnie Nga Kwan Choy & Kenneth Kai Wang Li

Authors
  1. Jeffrey Chi Wang Chan
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  2. Bonnie Nga Kwan Choy
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  3. Orlando Chia Chieh Chan
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  4. Kenneth Kai Wang Li
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Corresponding author

Correspondence to Kenneth Kai Wang Li.

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Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (place name of institute/committee) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Jeffrey CW Chan and Bonnie NK Choy are joint first authors of the paper and contributed equally in the present study.

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Chan, J.C.W., Choy, B.N.K., Chan, O.C.C. et al. Early intraocular pressure change after peripheral iridotomy with ultralow fluence pattern scanning laser and Nd:YAG laser in primary angle-closure suspect: Kowloon East Pattern Scanning Laser Study Report No. 3. Graefes Arch Clin Exp Ophthalmol 256, 363–369 (2018). https://doi.org/10.1007/s00417-017-3860-1

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  • DOI: https://doi.org/10.1007/s00417-017-3860-1

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