Optimum size of iridotomy in uveitis

Agraval, U., Qi, N., Stewart, P. , Luo, X. , Williams, G., Rotchford, A. and Ramaesh, K. (2015) Optimum size of iridotomy in uveitis. Clinical and Experimental Ophthalmology, 43(7), pp. 692-696. (doi:10.1111/ceo.12528) (PMID:25881493)

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Abstract

The failure of neodymium-doped yttrium aluminium garnet (Nd:YAG) peripheral iridotomy (PI) to prevent and relieve primary acute angle-closure glaucoma (AACG) has been well documented in the literature and has been attributed to an inadequate size of PI.[1] In cases of uveitis and iris bombe-associated AACG the failure rate is significantly greater, in the region of 40–61%.[2, 3] We present a case of a recurrence of AACG in a uveitic patient despite having a patent PI. We believe a much larger PI is required to prevent recurrent episodes of AACG in a uveitic eye. Therefore, we constructed and applied a mathematical model to determine the optimal size of iridotomy and to help understand and modify treatment options. A 22-year-old female presented to the eye casualty with a 1 day history of a severely painful left eye, headache, nausea and vomiting. Her vision was counting fingers in the left eye and 6/6 in the right (Figs 1a, 2a,2b). She attended 3 weeks go prior to this presentation with a similar episode, treated with Nd:YAG PI. She has a history of left chronic anterior uveitis resulting in raised intraocular pressure (IOP), which remained stable following insertion of Ahmed valve and cataract surgery, 5 months prior to her presentation.

Item Type:Articles (Letter)
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Luo, Professor Xiaoyu and Ramaesh, Dr Kanna and Stewart, Dr Peter
Authors: Agraval, U., Qi, N., Stewart, P., Luo, X., Williams, G., Rotchford, A., and Ramaesh, K.
College/School:College of Medical Veterinary and Life Sciences
College of Science and Engineering > School of Mathematics and Statistics > Mathematics
Journal Name:Clinical and Experimental Ophthalmology
Publisher:Wiley
ISSN:1442-6404
ISSN (Online):1442-9071
Copyright Holders:Copyright © 2015 Wiley
First Published:First published in Clinical and Experimental Ophthalmology
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher.

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