Effectivity of Nd Yag PI in treatment of acute primary angle closure glaucoma.

A Prospective hospital based study to note the efficacy of Nd Yag Peripheral Iridotomy (PI) in the treatment of acute primary angle closure glaucoma was carried out in Nepal Eye Hospital from Jan 2007 to Jan 2008. All the Patients (n=50) with acute primary angle closure glaucoma admitted to our hospital were selected for the study. Patients with secondary angle closure glaucoma were excluded. It is more common in age of 56-65 years (20%), in females (70%), and in tibetoburman ethnic group (56%). Mean duration of presentation to hospital was 5 days (22%) (Range 4-7 days). Grade 1 Angle closure was present in 74%. All 50 patients (100%) with AACG had undergone Yag PI. Out of 50 patients, 11 patients (22%) were surgically operated i.e. trabeculectomy. Among 11, 1 patient (9%) who had undergone trabeculectomy had presented with acute on chronic angle closure glaucoma. Majority of cases (66%) presented with visual acuity (VA) 1/60-PL at the time of presentation and the Intraocular pressure (IOP) in affected eye was 31-40 mmHg (42%). After performing Yag PI the mean visual acuity in the affected eye at the time of discharge was 6/60 (20%) and the IOP was 12 mmHg (40%). Prolonged duration of attack, elderly age, acute on chronic angle closure glaucoma, very high IOP at presentation, patients needing repeat Yag PI were found to have failure Yag PI. In this study 78% eyes had controlled IOP following Yag PI.