For patients with APAC, when iridotomy is not possible, iridoplasty is at least as effective as medical management in lowering IOP in the short term. The effectiveness of iridoplasty in preventing primary angle closure or primary angle-closure glaucoma is unclear. A randomized prospective trial comparing iridotomy alone to iridotomy and iridoplasty showed no difference in IOP reduction between the 2 groups at 1 year, but there was less PAS formation at 1 year in the iridoplasty plus iridotomy group. A randomized prospective study comparing peripheral iridoplasty to prostaglandin analogue therapy showed that prostaglandin analogue therapy was significantly more effective in IOP control at 1 year. A retrospective review of iridoplasty in plateau iris reported that the angle recess was wider at 6-year follow-up, which may help slow the development of PAC. (See also Chapter 9, Treatment Controversies sidebar.)
Narayanaswamy A, Baskaran M, Perera SA, et al. Argon laser peripheral iridoplasty for primary angle-closure glaucoma: a randomized controlled trial. Ophthalmology. 2016;123(3):514–521.
Sun X, Liang YB, Wang NL, et al. Laser peripheral iridotomy with and without iridoplasty for primary angle-closure glaucoma: 1-year results of a randomized pilot study. Am J Ophthalmol. 2010;150(1):68–73.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.