Re-Elevation of Intraocular Pressure after Peripheral Laser Iridotomy in Patients with Closed Angle

Duk Kyu Choi; Sungmin Hyung

doi:10.3341/jkos.2011.52.6.716

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Choi and Hyung: Re-Elevation of Intraocular Pressure after Peripheral Laser Iridotomy in Patients with Closed Angle

Original Article

J Korean Ophthalmol Soc 2011;52(6):716-720.

Published online: 31 August 2011

DOI: https://doi.org/10.3341/jkos.2011.52.6.716

Re-Elevation of Intraocular Pressure after Peripheral Laser Iridotomy in Patients with Closed Angle

Duk Kyu Choi, MD, Sungmin Hyung, MD, PhD

Department of Ophthalmology, School of Medicine, Chungbuk National University, Cheongju, Korea

Address reprint requests to Sungmin Hyung, MD, PhD, Department of Ophthalmology, Chungbuk National University Hospital #410 Seongbong-ro, Heungdeok-gu, Cheongju 361-711, Korea Tel: 82-43-269-6368, Fax: 82-43-264-5263, E-mail: smh@chungbuk.ac.kr

Received 19 November 2010 Revised 8 March 2011 Accepted 3 May 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To investigate the long-term effects of maintenance of intraocular pressure (IOP) after peripheral laser iridotomy (PLI) in patients with closed angle.

Methods

The patients who received PLI were assessed and divided into 2 groups. There were 38 patients (41 eyes) with a history or ocular findings of acute angle-closure attack in Group A, and 54 patients (70 eyes) who underwent prophylactic PLI in Group B. IOP over 18 mm Hg was considered to be re-elevated. The number of patients with re-elevated IOP and the duration until the re-elevation was investigated.

Results

The amount of IOP elevation immediately after PLI at 6, 24, and 48 months was 0.9, 2.5, and 2.6 mm Hg in Group A, and 0.1, 0.5, 0.5 mm Hg in Group B, respectively. The IOP re-elevation rate was 26.8, 40.0, and 51.4% at 6, 24, and 48 months in Group A and 8.6, 27.2, and 30.4% in Group B with statistically significant difference (p = 0.02, log-rank test).

Conclusions

Close, long-term observation for patients who receive PLI is recommended because there is a high risk of IOP re-elevation within 1 year after PLI. After prophylactic PLI, IOP was maintained under 18 mm Hg for a longer period than after acute angle-closure attack, thus performing preventive PLI should be considered.

Keywords: Angle closure, Intraocular pressure, Laser iridotomy

References

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Figure 1.

Change of intraocular pressure after peripheral laser iridotomy.

Figure 2.

Cumulative survival in each group. Survival means intraocular pressure ≤18 mm Hg.

Figure 3.

Patients rate whose intraocular pressure was re-ele-vated after peripheral laser iridotomy (PLI).

Table 1.

Baseline characteristics

	Group A	Group B	p-value
Age (mean ± SD, yr)	62.0 ± 8.7	61.7 ± 9.6	0.849^*
Sex (number of eyes)	41	70	0.638^†
Male	11	16
Female	30	54
Mean duration of follow-up (mean ± SD, mon)	58.2 ± 43.3	46.4 ± 28.1	0.124^*

^* t-test

^† Pearson's chi-square test.

Table 2.

Pre- and Post-PLI intraocular pressure (mean ± SD)

	Intraocular pressure (mm Hg)		p-value
	Pre-PLI	1 wk after PLI	p-value
Group A (n = 41)	46.8 ± 18.0	12.8 ± 3.3	0.001^*
Group B (n = 70)	15.1 ± 8.1	13.2 ± 2.6	0.061^*

PLI = peripheral laser iridotomy.

^* Paired t test.

Table 3.

Time duration until re-elevation in patients whose IOP was reelevated

	Group A (n = 18)	Group B (n = 17)	p-value
Time duration (mon)
Mean ± SD	10.0 ± 13.2	12.2 ± 10.2	0.089^*
Range	0.3-38.4	1.5-36.0

IOP = intraocular pressure.

^* Mann-Whitney U test.

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