Peripheral Iridotomy (LPI)...should you or shouldn't you?
A systematic review and meta-analysis just published looked at the progression of primary angle closure suspects (PACS) to more advanced stages of angle closure.
The results from 1,997 PACS patients with an average follow-up of 6.2 years, found 14.2% progressed to either primary angle closure (12.9%), acute angle closure (0.5%), or primary angle closure glaucoma (0.9%). Most importantly, laser peripheral iridotomy (LPI) significantly reduced the risk of progression to PAC by 2.49-fold (p < 0.001), with a number needed to treat of 15. Interestingly however, LPI's impact on progression to AAC and PACG was not statistically significant.
These findings remind us of potential benefit via prophylactic LPI in reducing angle closure progression - but also highlights the need for a balanced approach in clinical decision making when considering LPI's lack of demonstrated efficacy in terms of preventing all forms of progression.
-JRM
Go to the article in Nature: Eye HERE.
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