YAG laser peripheral iridotomy not tied to significant corneal endothelial damage: RCT
Primary angle closure glaucoma (PACG) accounts for nearly a half of global blindness caused by glaucoma. Laser peripheral iridotomy (LPI) is the conventional first-line treatment for individuals with primary angle closure. While LPI is generally felt to be safe, there have been reports of corneal complications including oedema and decompensation after argon laser iridotomies.
The short-term safety of Nd:YAG LPI has been established, but long-term evaluation is limited. The cell count and corneal cell morphology is relevant to corneal endothelial function and decompensation. Limited studies have reported the effect of Nd:YAG laser on endothelial hexagonality.
Liao C, et al performed an analysis to evaluate the influence of Nd:YAG LPI on corneal endothelial cell density (ECD) and morphology in PACS patients over 72 months which was published in British Open Ophthalmology Journal.
"Over 72 months of observation after YAG LPI, corneal ECD declined and morphology changed in both treated and fellow eyes of PACS patients. Although the difference in ECD between treated and fellow eyes was not statistically significant before 54 months, it became statistically significant at 72 months after LPI. That said, the difference was small (<1%).
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