Nd : YAG laser iridotomy in uveitic glaucoma

Purpose: To determine the survival of Nd:YAG laser peripheral iridotomy in those patients with angle closure glaucoma and iris bombe associated with u veitis. Methods: A retrospective review was performed on 11 patients of the Ocular Immunology Clinic of the Royal Victorian Eye and Ear Hospital who presented with uveitis, iris bombe due to extensive posterior synechiae and angle cl osure glaucoma. The date of iridotomy and where poss-ible the degree of inf lammation were noted, as was the date of failure of the iridotomy. A contro l group was constructed consisting of 65 patients who presented with acute angle closure glaucoma without a history of uveitis, who underwent Nd:YAG p eripheral iridotomy. The survival of the peripheral iridotomies in the two groups was calculated using Kaplan-Meier survival analysis. Median survival was compared using log-rank test. Results: In the study group of 11 patients, 28 iridotomies were performed o n 15 eyes; of these 28 iridotomies, 17 failed. Using Kaplan-Meier survival analysis the median time to failure was 85 days. In the control group of 65 patients, 66 iridotomies were performed on 66 eyes. None of the iridotomie s in the control group failed. There was a significant difference in the su rvival of the Nd:YAG iridotomies (P = 0.00015) between groups. Conclusion: There is a high early failure rate of Nd:YAG iridotomies in pat ients with angle closure glaucoma and iris bombe associated with uveitis.