J GlaucomaJuly 20182 citations

Pattern Scanning Laser (PASCAL) for Peripheral Iridoplasty in Eyes With Plateau Iris Syndrome: A Novel Application.

Midha Neha, Hoskens Kirsten, Mansouri Kaweh

View on PubMed DOI: 10.1097/IJG.0000000000000982

AI Summary

PASCAL laser iridoplasty for plateau iris syndrome was studied. It safely widened angles and reduced IOP, suggesting a promising alternative to current treatments for this glaucoma type.

Abstract

Purpose

The purpose of this study was to evaluate safety and efficacy of pattern scanning laser (PASCAL) for peripheral iridoplasty in eyes with plateau iris syndrome.

Materials and methods

This study was a retrospective review of cases that underwent PASCAL laser peripheral iridoplasty. Eyes with plateau iris syndrome confirmed on gonioscopy and ultrasound biomicroscopy were included in the study. Primary and secondary outcome measures were angle widening on gonioscopy and magnitude of intraocular pressure (IOP) reduction, respectively.

Results

Twelve eyes of 8 patients that completed 1-year follow-up were analyzed. Angle widening was noted in 46% of treated quadrants by at least 1 grade (Shaffer classification) at 1-month follow-up. A statistically significant IOP reduction was noted at 1 year from 20.6±4.8 to 17.8±3.8 mm Hg (P=0.01). At 1 month, 8 of 12 eyes (66.6%) achieved gonioscopic success (widening of the angle by at least 1 grade in 2 of 4 quadrants). At 1 year, 6 of 12 eyes (50%) achieved tonometric success (20% reduction or 3 mm Hg IOP reduction from the baseline without addition of new antiglaucoma medications). No adverse effects associated with PASCAL laser peripheral iridoplasty were observed.

Conclusions

PASCAL laser iridoplasty can be a safe and effective alternative to argon laser peripheral iridoplasty in the management of eyes with plateau iris syndrome. Our findings need to be further validated on larger sample size and in different ethnicities.

MeSH Terms

AgedFemaleFollow-Up StudiesGlaucoma, Angle-ClosureGonioscopyHumansIntraocular PressureIridectomyIrisIris DiseasesLaser TherapyMaleMiddle AgedPlastic Surgery ProceduresRetrospective StudiesSyndrome

Shields Classification

Ch. 3Gonioscopy and Other Techniques for Assessing the Anterior Segment

Ch. 12Pupillary Block Glaucomas

Ch. 37Principles of Laser Surgery for Glaucoma

Key Concepts5

PASCAL laser peripheral iridoplasty resulted in angle widening in 46% of treated quadrants by at least 1 grade (Shaffer classification) at 1-month follow-up in eyes with plateau iris syndrome.

TreatmentCase seriesRetrospective reviewn=12 eyes of 8 patientsCh38Ch39

PASCAL laser peripheral iridoplasty achieved a statistically significant intraocular pressure (IOP) reduction at 1 year from 20.6±4.8 to 17.8±3.8 mm Hg (P=0.01) in eyes with plateau iris syndrome.

TreatmentCase seriesRetrospective reviewn=12 eyes of 8 patientsCh3Ch38Ch39

At 1 month, 8 of 12 eyes (66.6%) treated with PASCAL laser peripheral iridoplasty achieved gonioscopic success (widening of the angle by at least 1 grade in 2 of 4 quadrants) in eyes with plateau iris syndrome.

TreatmentCase seriesRetrospective reviewn=12 eyes of 8 patientsCh4Ch38Ch39

At 1 year, 6 of 12 eyes (50%) treated with PASCAL laser peripheral iridoplasty achieved tonometric success (20% reduction or 3 mm Hg IOP reduction from the baseline without addition of new antiglaucoma medications) in eyes with plateau iris syndrome.