Laser iridotomy vs surgical iridectomy. Have the indications changed?
A. H. Rivera, R. H. Brown and D. R. Anderson
The number of laser iridotomies in 1982 was more than four times the annual
rate of surgical iridectomies performed before the laser was in common use
at the Bascom Palmer Eye Institute, Miami. No single reason accounts for
the increase. Only a minority of the increase is due to a 32% increase in
our outpatient volume, a backlog of individuals with borderline indications
who had not undergone surgery, or the number of iridotomies performed
prophylactically for asymptomatic narrow angles. The proportion of eyes
treated for each of several classic indications (acute attacks, chronic
angle closure with pressure elevation or synechiae, aphakic pupillary
block, etc) remained the same. However, eyes with acute attacks and their
fellow eyes had iridotomy more promptly and more often with the
availability of laser. In addition, the laser was applied earlier in the
course of chronic angle closure. We believe that the increased use of an
easy, low-risk procedure represents an improvement in the quality of care.
