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Laser Iridoplasty Techniques for Narrow Angles and Plateau Iris Syndrome

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The Glaucoma Book

Abstract

The apparent mechanism of intraocular pressure (IOP) elevation in primary angle closure (PAC) is straightforward: the obstruction of aqueous to the trabecular meshwork (TM) by the peripheral iris, usually interacting with the lens, which is therefore termed papillary block. With age, the crystalline lens increases in diameter, moving the peripheral iris forward and/or increasing pupil block, thus narrowing the angle. The conundrum that arises is determining when the threshold of occludability has been reached. Most epidemiological studies have chosen to define this point as when 270° or more of the posterior (pigmented) trabecular meshwork is not visible on gonioscopy; however, this threshold is arbitrary and has not been validated. The issue of angle compression has not been addressed. Nevertheless, at this time, the literature does not purport any other definition to be of greater accuracy and thus this is the operational definition used in this chapter.

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Author information

Authors and Affiliations

  1. Department of Ophthalmology, University of Toronto, Toronto, ON, Canada

    Baseer U. Khan MD, FRCS(C)

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  1. Baseer U. Khan MD, FRCS(C)
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Editors and Affiliations

  1. 2889 10th Avenue, N., Palm Springs, 33461, USA

    Paul N. Schacknow

  2. Casey Eye Institute, Dept. Ophthalmology, Oregon Health & Sciences University, SW. Terwilliger Blvd. 3375, Portland, 97201-4197, USA

    John R. Samples

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Khan, B.U. (2010). Laser Iridoplasty Techniques for Narrow Angles and Plateau Iris Syndrome. In: Schacknow, P., Samples, J. (eds) The Glaucoma Book. Springer, New York, NY. https://doi.org/10.1007/978-0-387-76700-0_62

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  • DOI: https://doi.org/10.1007/978-0-387-76700-0_62

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