LPI reduces IOP elevation in pigment dispersion syndrome

This long-term prospective study found that laser peripheral iridotomy (LPI) significantly reduces the risk of IOP elevation in eyes with pigment dispersion syndrome (PDS). The results also suggest that drug-induced mydriasis was effective at identifying PDS eyes at risk of progressing to ocular hypertension.

Seventy-two patients underwent phenylephrine testing. The 29 patients with a positive phenylephrine test result were considered to be at high risk for succeeding IOP decompensation, while the 43 patients who tested negative were considered low risk. No patient had one eye that was at high risk and the other at low risk.

For the 29 high-risk patients, one eye was randomly assigned to LPI and the fellow eye was left untreated. The eyes of the 43 low-risk patients were left untreated.

At 10 years’ follow-up, 3 of 21 high-risk eyes (14.3%) that underwent LPI had a significant pressure elevation (defined as a 5 mm Hg increase) compared to 13 of 21 (61.9%) untreated high-risk eyes. In the low-risk group, 4 of 35 (11.4%) eyes had a significant increase in pressure.

The results demonstrate that performing LPI on high-risk eyes reduced the rate of IOP elevation to the same level as low-risk eyes.