Quantitative assessment of changes in anterior segment morphology after argon laser peripheral iridoplasty: findings from the EARL study group.

IMPORTANCE: Argon laser peripheral iridoplasty (ALPI) could be effective in widening residual angle closure following laser peripheral iridotomy (LPI). BACKGROUND: We investigated changes in angle parameters following ALPI and its safety profile in this study. DESIGN: Retrospective, observational case series. PARTICIPANTS: The records from a single centre, of 36 patients (60 eyes) who underwent ALPI, for residual angle closure following LPI, were reviewed. METHODS: We analysed anterior chamber parameters in anterior segment optical coherence tomography (ASOCT) images using customized software pre- and post-ALPI. Paired t-test was used to compare changes. MAIN OUTCOME MEASURES: ASOCT parameters analysed included angle opening distance (AOD 500 and 750), trabecular iris surface area (TISA 500 and 750), anterior chamber width (ACW), anterior chamber volume (ACV), angle recess area (ARA), anterior chamber area (ACA), anterior chamber depth (ACD) and lens vault (LV). RESULTS: There was a mean increase in AOD 500 (0.05 vs. 0.16 mm, P < 0.001), AOD 750 (0.15 vs. 0.27 mm, P < 0.001), TISA 500 (0.010 vs. 0.038 mm2 , P < 0.001), TISA 750 (0.039 vs. 0.102 mm2 , P < 0.001), ACV (89.76 vs. 102.25 mm3 , P = 0.01), ARA 500 (0.015 vs. 0.033 mm2 , P < 0.001) and ARA 750 (0.044 vs. 0.088 mm2 , P < 0.001). There was no significant change in ACW, ACD, ACA and LV. Mean intraocular pressure (IOP) decreased post-ALPI (17.2 vs. 15.7 mmHg, P = 0.002). The mean follow-up duration was 2.1 years (range 0.5-5 years). CONCLUSIONS AND RELEVANCE: ALPI results in changes to the angle morphology and lowered IOP in eyes with residual angle closure. Our findings suggest a possible role for ALPI in eyes with residual angle closure following peripheral iridotomy.

Micropulse transscleral diode laser cyclophotocoagulation in the treatment of refractory glaucoma.

BACKGROUND: Transscleral diode laser cyclophotocoagulation (TSCPC) is an established method of treatment for refractory glaucoma, but is associated with significant complications. This study evaluates the efficacy and safety of a new form of TSCPC using micropulse diode laser and trans-pars plana treatment with a novel contact probe. METHODS: Prospective interventional case series of 40 eyes of 38 consecutive patients with refractory glaucoma treated with micropulse TSCPC with a novel probe. Outcomes measured were success, hypotony and response rates. RESULTS: The mean age of patients was 63.2 +/- 16.0 years. The mean follow-up period was 16.3 +/- 4.5 months. The mean intraocular pressure (IOP) before micropulse TSCPC was 39.3 +/- 12.6 mmHg. Mean IOP decreased to 31.1 +/- 13.4 mmHg at 1 day, 28.0 +/- 12.0 mmHg at 1 week, 27.4 +/- 12.7 mmHg at 1 month, 27.1 +/- 13.6 mmHg at 3 months, 25.8 +/- 14.5 mmHg at 6 months, 26.6 +/- 14.7 mmHg at 12 months and 26.2 +/- 14.3 mmHg at 18 months (P < 0.001 at all time points). No patient had hypotony or loss of best-corrected visual acuity. The overall success rate after a mean of 1.3 treatment sessions was 72.7%. CONCLUSION: Micropulse TSCPC is a safe and effective method of lowering IOP in cases of refractory glaucoma and is comparable with conventional TSCPC.

Micropulse P3™ (MP3) Laser for Glaucoma: An Innovative Therapy.

How to cite this article: Aquino MC, Lim D, Chew PTK. Micropulse P3™(MP3) Laser for Glaucoma: An Innovative Therapy. J Curr Glaucoma Pract 2018;12(2):51-52.