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    Argon laser iridoplasty effective in occludable eyes treated with iridotomy

    Argon laser peripheral iridoplasty (ALPI) significantly widens the anterior chamber angle circumferentially in eyes with occludable angles treated with laser peripheral iridotomy, researchers say.

    ALPI also reduces diurnal IOP fluctuation and might limit damage to the trabecular meshwork, reported Rupert R.A. Bourne, of Anglia Ruskin University in Cambridge, United Kingdom, and colleagues.

    They published their finding in the British Journal of Ophthalmology.

    In ALPI, clinicians direct an argon laser to create a circle of burns on the peripheral iris, contracting the iris stroma near the angle.

    ALPI widens the anterior change angles of eyes presenting with plateau iris syndrome where the angle remains occludable after laser peripheral iridotomy. It has been used in both acute primary angle closure (PAC) and primary angle closure glaucoma (PACG).

    Immediately after an angle closure attack, ALPI has proven more effective than systemic medications in lowering IOP.

    Diurnal IOP fluctuation decreases with increases in the dimensions of the anterior change angle in untreated patients with a diagnosis of PAC suspect, or PAC in both eyes.

    Bourne and colleagues wanted to know how temporal change in anterior chamber angle anatomy and diurnal IOP following ALPI in eyes with gonioscopically occludable angles post laser peripheral iridotomy compared with eyes receiving no further treatment.

    They recruited 22 patients whose eyes remained gonioscopically occludable after being treated with laser peripheral iridotomy. They randomly assigned 11 eyes to receive ALPI and 11 to receive no further treatment.

    They examined the eyes with swept-source optical coherence tomography (OCT) and measured their IOP with Goldmann tonometry.

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