31/12/2018
Δημοσιεύθηκε στο Acta Ophthalmologica η μελέτη μας για το γκρουπ γλαυκωματικων ασθενών με σύνδρομο πλατό ίριδας (iris plateau)
Long term follow-up of patients with plateau iris syndrome
after treatment with argon laser peripheral iridoplasty
G. Tsokolas1
, G. Tzamos2
, A. Datta2
1
University Hospitals Southampton NHS Foundation Trust, Eye Unit,
Southampton, United Kingdom, 2
NHS Lanarkshire, Ophthalmology
Department, East Kilbride, United Kingdom
Purpose: To assess safety and efficacy of argon laser peripheral
iridoplasty (ALPI) in controlling the intraocular pressure (IOP) in
patients with plateau iris syndrome (P*S) in NHS Lanarkshire over a
period of 7 years.
Methods: Retrospective case series. We report detailed demographic
details and ophthalmic findings including visual acuities, refraction,
presenting IOP, Central Corneal Thickness (CCT), Cup-to-Disc Ratio
(CDR) and ocular comorbidities. Key areas of focus post-ALPI were
the IOP control, the need for topical antiglaucoma medication, the
need for cataract or filtration surgery, the progression of optic
neuropathy and the complications post-procedure.
Results: 9 patients (17 eyes) were identified to have received ALPI for
confirmed P*S on gonioscopy performed by a single consultant. All
patients presented with repeat angle closure attack despite patent
iridotomy. Most common complication was prolonged iritis (2 out of 17
eyes). Pre-ALPI IOP ranged between 10–60 mmHg with a mean of
30.6 mmHg. The mean follow-up was 29.5 months, ranging from
2 weeks to 7 years. 1 eye required trabeculectomy, 4 eyes required
repeat ALPI and 1 showed progression of optic neuropathy. Post-ALPI
IOP ranged between 12–32 mmHg with a mean of 19.4 mmHg at last
follow-up. Pre and post-ALPI IOP difference was statistically significant
(p = 0.0175). At last follow up, 6 eyes were off topical drops, 5 required
monotherapy, 2 required dual therapy and 3 required triple therapy.
Conclusions: This study shows ALPI to be an effective and safe means
of managing acute IOP rise in patients who presented with repeat angle
closure attack despite patent iridotomy. These patients need close
monitoring as they may require other intervention like ocular
hypotensives, cataract and glaucoma surgery. A larger sample size
and longer follow up will improve the validity and quality of the study.
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© 2018 The Authors
Acta Ophthalmologica © 2018 Acta Ophthalmologica Scandinavica Foundation�