{"id":3369,"date":"2022-11-21T10:53:18","date_gmt":"2022-11-21T10:53:18","guid":{"rendered":"https:\/\/profmunteanu.ro\/?p=3369"},"modified":"2023-09-05T09:52:37","modified_gmt":"2023-09-05T08:52:37","slug":"iridotomia-laser-ce-este-si-cand-se-recomanda","status":"publish","type":"post","link":"https:\/\/profmunteanu.ro\/en\/iridotomia-laser-ce-este-si-cand-se-recomanda\/","title":{"rendered":"Laser iridotomy: what is it and when is it recommended?"},"content":{"rendered":"
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t

Laser iridotomy: what is it and when is it recommended?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t
\n\t\t\t
<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t

Iridotomia laser este o procedur\u0103 minim invaziv\u0103 utilizat\u0103 \u00een tratamentul glaucomului \u0219i prevenirea atacurilor de glaucom cu unghi \u00eenchis. Iridotomia laser const\u0103 \u00een crearea unei mici deschideri \u00een irisul ochiului cu ajutorul unui laser specializat. Aceast\u0103 interven\u021bie permite drenarea adecvat\u0103 a lichidului intraocular \u0219i reduce riscul de acumulare a presiunii intraoculare, care poate afecta nervul optic \u0219i vederea. Indica\u021biile pentru iridotomia laser includ unghi \u00eengust, prevenirea glaucomului cu unghi \u00eenchis \u0219i reducerea riscului de atac de glaucom. Aceast\u0103 procedur\u0103 sigur\u0103 \u0219i eficient\u0103 ofer\u0103 pacien\u021bilor o op\u021biune de tratament important\u0103 pentru s\u0103n\u0103tatea ochilor.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

\n\t\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t
\n\t\t\t
<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t

1. What is laser iridotomy?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t

Peripheral laser iridotomy (also described as \"laser iridotomy\" or simply called \"iridotomy\") is a medical procedure that uses a laser device to create a hole in the iris, thereby allowing aqueous humor to pass directly from the posterior chamber to the anterior chamber and , consequently, relieving a pupillary block. It is commonly used to treat a wide range of clinical conditions, including primary angle-closure glaucoma, primary camerular angle closure (narrow angle and no signs of glaucomatous optic neuropathy), eyes suspected of primary angle closure (patients with reversible obstruction) and even eyes with secondary causes of iridocorneal angle closure.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

\n\t\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t

In the mid-1970s, the argon laser became the first to be commonly used to perform non-invasive iridotomy. Although well absorbed by the iris pigment, the argon laser (and the Nd:YAG-KTP laser, which is often referred to as the \"argon laser\") used for iridotomy was associated with some complications and relatively high failure and subsequent closure rates. Q-switched Nd:YAG laser devices (1064 nm YAG laser) emerged in the 1980s and proved to be effective in light-coloured irises because its mechanism of action was independent of the melanin content of the iris. Moreover, it required much less total energy than pure argon\/Nd:YAG-KTP 532 nm laser iridotomy, and achieved a superior single-treatment success rate with lower risk of subsequent closure and was less likely to cause corneal, lens and retinal damage.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

\n\t\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t

2. When is this procedure indicated?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t

Iridotomia periferic\u0103 cu laser (LPI) este indicat\u0103 pentru a preveni sau trata pacien\u021bii suspec\u021bi de blocaj pupilar relativ prin crearea unei c\u0103i alternative pentru fluxul apos. Folosit \u00een principal pentru pacien\u021bii cu \u00eenchidere primar\u0103 de unghi, poate fi util \u0219i \u00een glaucomul<\/a> secundar cu unghi \u00eenchis \u0219i \u00een gestionarea altor tipuri de glaucom cu bloc pupilar asociat. Unghiul iridocornean trebuie, \u00een toate cazurile, examinat cu aten\u021bie dup\u0103 LPI pentru a exclude alte mecanisme ale unui unghi \u00eenchis care necesit\u0103 tratament.<\/p>


- Acute primary angle closure (APAC)
- Contralateral eye in acute primary angle closure
- Suspected primary angle closure, narrow\/occlusive angle
- Primary angle closure glaucoma and primary angle closure
- Secondary angle closure with pupillary block
- Flat iris configuration and flat iris syndrome
- Misdirection of aqueous humor, cilio-lenticular block, ciliary block or malignant glaucoma
- Pigment dispersion syndrome (PDS), pigmentary ocular hypertension (POH) and pigmentary glaucoma (PG)
- Congenital abnormalities that may be associated with secondary glaucoma
- Systemic drugs with effects on the iridocorneal angle
<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

\n\t\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t
\n\t\t\t
<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t

3. Contraindications of the procedure<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t

The following contraindications should be managed before performing an IPL:<\/p>