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Pattern Scanning Laser (PASCAL) for Peripheral Iridoplasty in Eyes With Plateau Iris Syndrome

A Novel Application

Midha, Neha MD*; Hoskens, Kirsten MD*; Mansouri, Kaweh MD, MPH*,†

doi: 10.1097/IJG.0000000000000982
Online Articles: Case Report/Small Case Series

Purpose: The purpose of this study was to evaluate safety and efficacy of pattern scanning laser (PASCAL) for peripheral iridoplasty in eyes with plateau iris syndrome.

Materials and Methods: This study was a retrospective review of cases that underwent PASCAL laser peripheral iridoplasty. Eyes with plateau iris syndrome confirmed on gonioscopy and ultrasound biomicroscopy were included in the study. Primary and secondary outcome measures were angle widening on gonioscopy and magnitude of intraocular pressure (IOP) reduction, respectively.

Results: Twelve eyes of 8 patients that completed 1-year follow-up were analyzed. Angle widening was noted in 46% of treated quadrants by at least 1 grade (Shaffer classification) at 1-month follow-up. A statistically significant IOP reduction was noted at 1 year from 20.6±4.8 to 17.8±3.8 mm Hg (P=0.01). At 1 month, 8 of 12 eyes (66.6%) achieved gonioscopic success (widening of the angle by at least 1 grade in 2 of 4 quadrants). At 1 year, 6 of 12 eyes (50%) achieved tonometric success (20% reduction or 3 mm Hg IOP reduction from the baseline without addition of new antiglaucoma medications). No adverse effects associated with PASCAL laser peripheral iridoplasty were observed.

Conclusions: PASCAL laser iridoplasty can be a safe and effective alternative to argon laser peripheral iridoplasty in the management of eyes with plateau iris syndrome. Our findings need to be further validated on larger sample size and in different ethnicities.

*Glaucoma Research Center, Montchoisi Clinic, Swiss Vision Network, Lausanne, Switzerland

Department of Ophthalmology, University of Colorado School of Medicine, Denver, CO

Supported in part by the Swiss Glaucoma Research Foundation, Lausanne, Switzerland.

Disclosure: K.M.: Santen (consultant), Sensimed (consultant), Topcon (speaking fees), Alcon (speaking fees), Allergan (speaking fees), Optovue (speaking fees), ImplanData (consultant). The remaining authors declare no conflict of interest.

Reprints: Kaweh Mansouri, MD, MPH, Glaucoma Research Center, Montchoisi Clinic, 10, Chemin des Allinges, Lausanne 1006, Switzerland (e-mail:

Received February 18, 2018

Accepted April 30, 2018

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