Long-term success of argon laser peripheral iridoplasty in the management of plateau iris syndrome☆
Section snippets
Materials and methods
We reviewed the charts of all patients with plateau iris syndrome who were treated with ALPI at the New York Eye and Ear Infirmary from 1983 to 1991 and who were followed continuously for at least 6 years afterward. Patients with less than 6 years of follow-up or who were followed elsewhere were excluded from analysis.
Plateau iris syndrome was diagnosed by the presence of spontaneous appositional angle closure on darkroom indentation gonioscopy to at least the upper border of the pigmented band
Results
A total of 26 ALPI procedures were performed in 23 eyes (10 right eyes, 13 left eyes) of 14 patients (4 men, 10 women). Mean age of the 14 patients was 61±8.7 years (range, 45–76 years). Only 1 Filipino patient was not Caucasian. Mean follow-up time was 78.9±8.0 months (range, 72–188 months). Of the 5 untreated eyes, 4 were judged sufficiently open so as not to require ALPI, and 1 was prephthisical with no light perception vision. All patients with plateau iris and appositional closure to the
Discussion
Gradle and Sugar11 observed angle-closure glaucoma in a number of eyes with normal anterior chamber depths. In 1955 Higgett and Smith12 described 2 cases of angle-closure glaucoma in younger patients who had a flat iris and a narrow angle secondary to an abrupt angulation at the root of the iris. Chandler described a 37-year-old woman with recurring intermittent angle-closure glaucoma despite a patent iridectomy who was successfully treated with pilocarpine.7 Tornquist1 was the first to use the
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Manuscript no. 220740.
Supported in part by the Steven and Shelley Einhorn Research Fund of the New York Glaucoma Research Institute, New York, New York.
The authors have no financial interest in any device or technique described in this manuscript.