Sequential argon-YAG laser iridotomies in dark irides.

Laser iridotomies in dark coloured irides are associated with higher complication and failure rates. A prospective clinical study to evaluate the use of the argon and Nd:YAG laser in sequential combination for iridotomy was carried out on 20 eyes of 13 patients with dark irides. Patent iridotomies were achieved in single treatment sessions for all the eyes. Iridotomy closure was observed in one eye during a mean follow-up period of 14 months (range 6-20 months). Complications from the treatment occurred in five eyes and were minor. Total mean energy used for the argon and Nd:YAG stages respectively were a third of most studies on pure argon and Nd:YAG iridotomies. Sequential argon-YAG laser iridotomy combines most of the advantages of both laser types while avoiding some of their disadvantages. We find it a safe and effective tool for iridotomy in otherwise difficult dark irides.