Comparing Nd:YAG Laser and Sequential Double Frequency YAG-Nd:YAG Laser Iridotomy

Prince of Songkla University82 enrolled

Overview

No single type of laser or set of laser parameters is appropriate for all type of irides. Pure Nd:YAG laser iridotomy is very effective in the light color irides. It was considered as the gold standard for iridotomy. It, however, is less effective and causes some complication such as iris hemorrhage especially in patients with dark iris.

By using the double frequency YAG to make the initial bore and the Nd:YAG laser to complete the perforation, the technique should be able to effectively combine most of the advantages of both lasers whilst avoiding their disadvantages. It is possibly the ideal iridotomy technique to use in the Asian irides. The investigators aim to study the energy use for laser iridotomy comparing between the two techniques as well as objectively measure the variables associated with complications.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Angle Closure Glaucoma

Interventions

The sequential techniqueDEVICE

By using 'the double frequency YAG laser' to make the initial bore and 'the Nd:YAG laser' to complete the perforation on iris.

The pure Nd:YAG laser techniqueDEVICE

By using 'the pure Nd:YAG laser' to make a complete perforation on iris.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patient in need to have a laser iridotomy * primary angle closure glaucoma or * primary angle closure or * primary angle closure suspect (needed repeated pupil dilation) or * fellow eyes of acute angle closure crisis, and * Age of at least 18 years, and * Dark iris patients (only black and dark brown color) Exclusion Criteria: * Eye with acute angle closure crisis * Active conjunctiva or corneal infection or inflammation * Active anterior uveitis * History of any prior laser treatment * History intraocular surgery * Eye with corneal scar * Corneal haziness obscure iridotomy site * Endothelial cell count less than 1000 cells/mm2 (pre-laser) * Iris color other than black or dark brown * Inability to sit at the slit lamp to have laser done

Locations (1)

Weerawat Kiddee

Hat Yai, Changwat Songkhla, Thailand

Outcomes

Primary Outcomes

Laser energy

Total energy used to create patency on the iris

Time frame: 1-hour

Secondary Outcomes

Bleeding

iris bleeding immediate after laser reported as Yes or No

Time frame: 1-hour

Corneal endothelial cell count

Corneal endothelial cell count directly over the area of laser

Time frame: 12-month

Central corneal thickness

Time frame: 12-month

Patency of iridotomy

Iridotomy patency is confirmed objectively reported as yes or no

Time frame: 12-month

Intraocular pressure spike

Intraocular pressure spike if present mean that IOP evelation of at least 8mmHg from baseline intraocular pressure

Time frame: 1-hour

Data from ClinicalTrials.gov

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