A prospective, randomized comparison of Nd:YAG and sequential argon-YAG laser iridotomy in Filipino eyes

Abstract

Objective: This study compared Nd:YAG laser alone versus sequential argon-Nd:YAG laser iridotomy in terms of success in attaining patency, differences in visual acuity and intraocular pressure, and rate of complications in dark irides of Filipinos.

Methods: A prospective, randomized, controlled trial was performed involving patients requiring laser iridotomy who were randomized either to Nd:YAG laser or sequential argon-Nd:YAG laser iridotomy. Iris-perforation success rate, the average number of laser shots and amount of laser energy used, the intraocular pressure (IOP) after laser treatment, and the rate of complications were compared. The prelaser pupil size was correlated with the iris perforation success rate.

Results: Forty-one eyes underwent laser iridotomy (23 Nd:YAG and 18 sequential). All eyes had patent iridotomies. There was no difference between the two groups in terms of the number of Nd:YAG laser shots delivered (p = 0.97) and amount of Nd:YAG energy used (p = 0.64). The total amount of laser energy used was higher in the sequential group (p = 0.003). There was no significant difference in the IOP and complication rates after treatment. A positive correlation was seen between prelaser pupil size and number of Nd:YAG shots needed to enlarge (r = 0.38, p = 0.01).

Conclusion: Nd:YAG laser alone and sequential argon-Nd:YAG have comparable success in attaining patency of laser iridotomy, IOP control, and rate of complications in dark irides of Filipinos.