Q-switched neodymium-YAG laser iridotomy in patients in whom the argon laser fails
A. L. Robin and I. P. Pollack
We conducted a short-term prospective clinical study to evaluate Q-switched
neodymium-YAG laser iridotomy in 33 eyes with pupillary block glaucoma in
which the argon laser was unable to create an iridotomy. These eyes had
chronic angle closure glaucoma (11 eyes), acute angle closure glaucoma
(five eyes), pseudophakic pupillary block (seven eyes), uveitic pupillary
block (three eyes), and contralateral eyes (five eyes); also included were
both eyes of a patient with a head tremor. In all eyes, a patent iridotomy
was created in one treatment session, with a mean of 5 +/- 5 pulses and a
mean total energy of 55 +/- 120 millijoules. Complications included
iridotomy closure (two eyes with preexisting active uveitis), focal
nonprogressive corneal opacities (six eyes), and minimal bleeding from the
iridotomy margin (12 eyes). Q-switched neodymium-YAG laser iridotomy
appears to be an effective next step in the management of pupillary block
glaucoma prior to surgical iridectomy when argon laser iridotomy fails.
