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Nd:YAG laser iridotomy does not prevent onset of pigmentary glaucoma
Ophthalmology. 2011;118(3):468-473.
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Nd:YAG laser peripheral iridotomy proved ineffective in halting the progression of pigment dispersion syndrome with ocular hypertension to pigmentary glaucoma, a study found.
"This study was powered to detect large treatment differences only, and clearly may have missed smaller yet still clinically relevant treatment differences," the study authors said. "However, it is the largest prospective randomized controlled trial for [pigment dispersion syndrome] that has been conducted to date with very carefully evaluated outcomes and provides essential data that may be used in future meta-analyses to resolve this important clinical question."
The study included 116 eyes of 116 patients with pigment dispersion syndrome and ocular hypertension. Fifty-seven patients were randomized to undergo laser treatment and 59 patients were assigned to have no laser treatment.
Median follow-up was 35.9 months. Patients were evaluated at 4-month intervals. IOP, Snellen visual acuity and visual fields were evaluated at baseline and all follow-up points.
Outcome data were available for 52 patients in the laser group and 53 patients in the non-laser group.
Eight eyes in the laser treatment group and three eyes in the non-laser group progressed to pigmentary glaucoma within 3 years. The between-group difference was statistically insignificant. The median interval to conversion was 19.8 months in the laser group and 12.9 months in the non-laser group.
Eight eyes in the laser group and nine eyes in the control group started medical treatment. Both groups had similar time to visual field progression and initiation of topical therapy, the authors reported.