Clinical outcome of iridotomy with Argon-YAG laser at a tertiary care center in Karachi, Pakistan.

OBJECTIVE To assess the the efficacy and early and late complications of Argon-YAG combined laser iridotomy in the outpatient department of a tertiary care hospital. METHODS This was a prospective observational study conducted at Aga Khan University Hospital Karachi, Pakistan. After detailed history taking and clinical examination, patients who had goniscopically evident closed angles and a positive provocative test were selected for laser iridotomy. They underwent iridotomy using Argon laser followed by YAG laser. The main outcome measures were patency of iridotomy at 6 months, angle grading at 6 months and early and late complications. RESULTS Overall 40 eyes of 30 patients underwent iridotomy. Of these 18 (60%) were female. At presentation, 26, 10, 2 and 2 eyes had primary angle closure glaucoma (PACG), prodromal stage of PACG, chronic angle closure glaucoma, and seculusio papillae with iris bombe secondary to uveitis, respectively. All the 40 iridotomies were patent at 6 months follow up. Majority of the eyes with primary acute angle closure glaucoma, and prodromal angle closure glaucoma had their angles opened from Grade 0 and Grade I to Grade III. At 6 months, 30 (75%) eyes had a good control of intraocular pressure (lOP). Intraoperative complication, encountered were microhyphaema in 14 eyes and 2 developed corneal burns. Postoperative complications were transient rise of IOP in 18 eyes and post-laser iritis in 32 eyes, but they responded to recommended treatment. CONCLUSIONS Iridotomy with Argon laser followed by Nd-YAG laser was associated with good clinical outcome and fewer complications in eyes with PACG.