Complications
This complication may be prevented by prompt reduction of intra-ocular pressure (IOP).
Once it occurs there is no specific immediate treatment.
This complication may be prevented by prompt reduction of IOP.
Between 30% and 41% of patients experience anterior chamber bleeding after LPI.[50]
Between 23% and 39% of patients experience cataract progression after LPI.[50]
The fellow eye, which usually shares the anatomical predisposition for increased pupillary block, is at high risk for developing acute angle closure.
An untreated fellow eye has a 40% to 80% risk of developing an acute attack.
It is recommended that the contralateral eye be treated prophylactically with laser peripheral iridotomy if the chamber angle is found to be anatomically narrow.[17][24][47][48][49]
Patients with primary angle-closure glaucoma (PACG) often present with higher IOP and more advanced visual field loss than those with primary open-angle glaucoma (POAG).[31] These finding suggest that PACG is a more IOP-dependent disease.
Following successful treatment of acute primary angle closure, there is some evidence that retinal nerve fibre layer thickness significantly decreases within 16 weeks after the attack.[23]
Adequate and prompt treatment with lowering of IOP will reduce the risk for permanent injury to the retinal ganglion cells and axons.
Between 6% and 10% of patients experience an IOP spike (8-17 mmHg increase from baseline) after LPI.[50]
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