Combined argon and Nd: YAG laser peripheral iridectomy: A new approach in clinical practice.

PURPOSE: To evaluate the therapeutic effect of combined argon and Nd: YAG laser peripheral iridectomy.

METHODS

151 cases (200 eyes) of primary angle-closure glaucoma and combined glaucoma were treated by combined procedure. Argon laser was the first used to create partial iridectomy in 2/3-3/4 thickness without penetrating pigmented epithelium, and then Nd: YAG laser was required to complete a patent iridectomy.

RESULTS

A successful iridectomy was achieved in all patients independent of any type of irides (100%). Iris penetration rate in one session presented in 95.0%. Complications appeared to be less common in our patients: iris bleeding was only seen in 5.0% cases; the postoperative inflammation was mild; corneal burns, localized lenticular opacities and closure of iridectomies were less frequent. The follow-up ranged from 3m to 6.5 years. The success rate in controlling IOP with/without medications were 99.0% except 2 eye failure. No attack occurred in 129 eyes with prophylactic laser therapy during the periods of follow-up.

CONCLUSION

Combined procedure had much more advantage over either the argon or Nd: YAG laser iridectomy. It tended to be more preferable for Asian patients with heavily pigmented and thick irides.