Evaluation of changes in intraocular pressure following YAG laser peripheral iridotomy in patients with primary angle-closure glaucoma

   Background. Glaucoma is a major public health concern, accounting for 8% of blindness worldwide and 16.7 % of blindness in Nigeria. Early diagnosis and reduction of intraocular pressure (IOP) are critical for preventing optic nerve damage. Although topical medications are generally used as initial therapy, uncontrolled IOP may require surgical intervention. Laser peripheral iridotomy (LPI) is a standard procedure for primary angle-closure glaucoma (PACG) that relieves pupillary block, lowers IOP, and reduces the risk of vision loss.

   Purpose. To evaluate changes in IOP following Nd:YAG laser peripheral iridotomy in patients with PACG.

   Materials and methods. A retrospective analysis of 104 medical records of patients with PACG treated at the Makkah Specialist Eye Hospital in Kano, Nigeria, from January 2020 to December 2024, was conducted. Included were patients aged 31–80 years, with IOP measurements before and after LPI. Changes in IOP were evaluated using the paired t-test.

   Results. In the majority of patients (54 patients, 51.9 %), the IOP level was 20–29 mm Hg, followed by the range 30–39 mm Hg (22 patients, 21.2 %), and the smallest number of patients had pressure 10–19 mm Hg (8 patients, 7.7 %). Ten patients were lost to follow-up. Among the remaining 94 patients, the majority (63 patients, 67 %) achieved IOP in the range of 10–19 mm Hg, followed by the range 20–29 mm Hg (20 patients, 21.3 %), and only 3 (3.2 %) patients had pressure remaining within 40–49 mm Hg. Mean IOP decreased significantly from 28.63 ± 9.50 mm Hg before LPI to 18.22 ± 8.54 mm Hg after LPI (t (93) = 11.30, p < 0.001).

   Conclusion. In this retrospective study, YAG laser peripheral iridotomy was associated with a statistically significant mean reduction in IOP of 10.4 mm Hg in patients with PACG, supporting its role as a first-line intervention in this patient population.

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