Angle-closure glaucoma: Iridotomy

Abstract

To avoid transient intraocular pressure (IOP) elevation, 1% apraclonidine hydrochloride ophthalmic solution should be administered 1 h before LPI. Brimonidine 0.15-0.2% has also been reported to be effective in preventing a transient IOP elevation associated with LPI [1, 2]. The more dilated a pupil is, the thicker the iris stroma will be and the higher the laser power necessary to complete the LPI. Therefore, the pupil should be maximally constricted before the procedure. For this purpose, 1-2% pilocarpine ophthalmic solution should be administered 30 min to 1 h before the procedure is started. Shining a bright light in the fellow eye during the procedure will also accomplish pupil constriction by the consensual light reflex. IOP should be controlled as much as possible before the procedure. Steroid ophthalmic solution should be administered if there is inflammation in the anterior chamber. © 2010 Springer-Verlag Berlin Heidelberg.