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Gonioplasty in angle closure glaucoma uncontrolled with a patent neodymium yttrium aluminum garnet laser iridotomy



Gonioplasty in angle closure glaucoma uncontrolled with a patent neodymium yttrium aluminum garnet laser iridotomy



Glaucoma 13(5): 149-151



Thirty-five eyes of patients with angle-closure glaucoma (21 chronic, ten subacute, and four with acute resolved stage) who had patent peripheral laser iridotomies were chosen for this study. All eyes initially were controlled by iridotomy with or without antiglaucoma medication but became uncontrolled after an average of 0.8 years. The cause of initial failure was gross damage to the meshwork in 57.1% of cases, plateau iris syndrome in 20%, and subtle damage in the rest. Gonioplasty was done in all eyes with a blue-green argon laser. Around 50% of these eyes could be controlled by gonioplasty. Such control can be expected in all eyes with angle-closure glaucoma, uncontrolled by iridotomy, who have a comparatively low prelaser intraocular pressure, who widen more than Grade I visibly during gonioplasty, and who have plateau iris syndrome, of the subacute or acute resolved variety.

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