Outpatient argon laser iridectomy for angle closure glaucoma: a two-year study.

A technique for iridectomy in the the treatment of angle-closure glaucoma utilizing laser beams has been developed. The operation is performed in two steps. In step 1 a partially penetrating burn of the iris is made to produce an iris hump. In step 2 a penetrating burn is used to pierce the crown of the previously produced hump. Tables 1, 2, and 3 summarize current recommendations and the detailed steps that must be followed (without exception) to achieve success with this technique. Of 22 phakic eyes, fellow eyes, or eyes with narrow-angle glaucoma, instantaneous, permanent iris perforation was produced in all except two. In these two, a second treatment on the following day produced a permanent perforation. Serious complications were encountered in only one patient who received treatment at a greater energy level than we now recommend. In that patient striate keratopathy became apparent, as well as a decrease in vision which has lasted five months. No significant complication was encountered in any eye treated with the currently recommended procedure.