Prophylatic laser iridotomy

Has anyone had this preventative treatment to avoid acute narrow angle
glaucoma and with what results, such as adverse side effects?

Tkx for input.
Barbara

Tkx very much for your import. I suppose my "other question" is - is
the risk of side effects worth taking when I have no symptoms (normal
IOP - no family history, etc.) but just the observation by a specialist
of "narrow angles"?

I find this such a difficult decision to make.

Many tkx
Barbara

Anon E. Muss wrote:
> On Tue, 04 Jul 2006 02:43:04 GMT, Barbara <(E-Mail Removed)> wrote:
>
>> Has anyone had this preventative treatment to avoid acute narrow angle
>> glaucoma and with what results, such as adverse side effects?
>
> I haven't had a laser peripheral iridotomy (PI) myself, but I've sent
> several patients to a local glaucoma sub-specialist who has performed
> this procedure on them.
>
> Properly performed laser PI appears to be relatively benign (low risk
> of ghost image, increased IOP, perhaps accelerating rate of cataract),
> especially considering how nasty an acute angle closure glaucoma
> attack can be.
>
> Any other questions?

Thank you for replying to my "difficult" decision.

I don't have increased IOP or symptoms suggesting intermittent
angle-closure - I don't know whether the angle is progressive
(goniosopic exam performed at 6-9 mth intervals). The specialist won't
take a chance on dilating my eyes but says he sees no reason to dilate
them at this time.

I am 64 and the specialist says the "box" is bound to get smaller as I
age; but it's very difficult to agree to a procedure when you are
feeling well and have never had any eye surgery and only wear drug store
magnifiers for small print. (No cataract at this time).

I will read the article you have reference.

Thank you so much for your time.
Barbara


Anon E. Muss wrote:
> On Tue, 04 Jul 2006 14:50:13 GMT, Barbara <(E-Mail Removed)> wrote:
>
>> Tkx very much for your import. I suppose my "other question" is - is
>> the risk of side effects worth taking when I have no symptoms (normal
>> IOP - no family history, etc.) but just the observation by a
>> specialist of "narrow angles"?
>
> Knowing the actual angle configuration via the Spaeth gonioscopic
> grading system would be helpful.
>
> I don't *normally* recommend surgery for patients with merely
> anatomically narrow angles (confirmed by gonioscopy).
>
> However, when *other risk factors* are present such as progressive
> narrowing of the angle, increased IOP, symptoms suggesting
> intermittent angle-closure, monocular patient, condition requiring
> frequent dilation, inability to reliably maintain follow-ups, etc.
> recommending a laser PI is a no-brainer.
>
>> I find this such a difficult decision to make.
>
> Get a second or third opinion, preferably from a fellowship trained
> glaucoma sub-specialist.
>
> Ask them a couple questions: 1. How narrow are your angles (i.e.,
> less than 90 degrees of trabecular meshwork visible, impending closure
> imminent?) and 2. Besides the presence of narrow angles, what other
> risk factors or reasons do you recommend surgery?
>
> Here's a great article written on the subject written by David
> Freidman, MD, MPH, of Wilmer Eye Institute in Baltimore (arguably the
> top ophthalmology residency program in the United States):
>
> <http://bjo.bmjjournals.com/cgi/content/full/85/9/1019>
>
> If it were *my eyes* and it was questionable (not definite either
> way), I would have laser PIs performed.
>
> Hope that helps.