• Ophthalmic Technology Assessment Committee, Hoskins Center for Quality Eye Care


    Preparation was coordinated by the American Academy of Ophthalmology Committee on Ophthalmic Procedures Assessment

    Ophthalmology, October 1994, Vol 101, 1749-1758 © 1994 by the American Academy of Ophthalmology. Click here for free access to the OTA.

    Reviewed for currency: 2014


    The article reviews the procedures of incisional iridectomy and laser iridotomy and compares them with regard to efficacy, skill required, safety, complications, and necessary follow-up care. A major advantage of laser iridotomy over incisional iridectomy is greater safety for the patient. Several rare but serious complications may occur after incisional iridectomy that are avoided by the laser technique. Despite its many advantages, the laser procedure can be a difficult technique to perform successfully.

    The success of laser iridotomy has had a profound impact on the treatment of pupillary-block glaucoma. By focusing attention on the importance of recognizing and diagnosing the different forms of angle closure, laser iridotomy has encouraged the improvement of gonioscopy skills and has increased the ophthalmologist’s awareness and understanding of the angle-closure glaucomas. Through the delivery of appropriate care to more patients earlier in the disease course, the laser iridotomy has dramatically improved the quality of car given to patients with all forms of angle-closure glaucoma. The improved safety of laser iridotomy compared to incisional iridectomy when performed by a skilled ophthalmologist allows more patients to be treated earlier in the disease course.