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Dysphotopsias after LPI tend to resolve

Issue: April 25, 2019

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Nazlee Zebardast

SAN FRANCISCO — Most patients who report new dysphotopsias after laser peripheral iridotomy for primary angle-closure glaucoma can be reassured that these manifestations are likely to resolve, Nazlee Zebardast, MD, told colleagues at the American Glaucoma Society meeting.

“[LPI] is a relatively safe procedure. Subjective visual dysphotopsias do occur, not uncommonly, after laser iridotomy in 2% to 16% of patients,” she said.

Zebardast and researchers at Aravind Eye Hospital undertook a prospective randomized trial in India to evaluate the frequency at which new dysphotopsias manifest after LPI and whether they resolve over time.

“This information is critical for how clinicians manage these symptomatic patients,” she said.

Recruited patients were bilaterally phakic with primary angle-closure suspect or primary angle-closure glaucoma in both eyes. At 6 months, data were available for 131 subjects who underwent superior LPI and 138 who underwent nasal/temporal LPI. Each subject underwent the same procedure at the same location in both eyes.

At the baseline exam 2 weeks postoperatively, 9.7% of subjects reported one or more new symptoms, with lines, glare and blurring being most common. Patients were statistically significantly less likely to report linear dysphotopsias at 6 months compared with 2 weeks postoperatively.

Between 2 weeks and 6 months, 6% of subjects reported one or more new dysphotopsias, with glare and blurring being most common. Overall, 11.5% of subjects reported resolution of dysphotopsias between 2 weeks and 6 months.

“Only 0.7% of all subjects who developed new dysphotopsias at 2 weeks had persistent dysphotopsias at 6 months after LPI, with no subject reporting linear dysphotopsias,” Zebardast said.

There was no difference in new dysphotopsias by location at 2 weeks or at 6 months, making either location a viable clinical option, she said. – by Patricia Nale, ELS

Reference:

Zebardast N. Resolution of visual dysphotopsias following laser iridotomy: 6 month follow-up. Presented at: American Glaucoma Society annual meeting; March 14-17, 2019; San Francisco.

Disclosure: Zebardast reports no relevant financial disclosures.