ive Evaluation of Intraocular Pressure Fluctuations Post Laser Peripheral Iridotomy in PACD spectrum

Monika Arora; Nitin Suryal; Anjali Roy; kajal yadav

ive Evaluation of Intraocular Pressure Fluctuations Post Laser Peripheral Iridotomy in PACD spectrum

Author(s)	Dr. Monika Arora, Dr. Nitin Suryal, Dr. Anjali Roy, Ms. kajal yadav
Country	India
Abstract	Abstract Background: Laser peripheral iridotomy (LPI) is the standard intervention for relieving the pupillary block component of primary angle-closure disease (PACD). Transient intraocular pressure (IOP) elevation may occur following LPI, but comparative data across primary angle-closure suspect (PACS), primary angle closure (PAC), and primary angle-closure glaucoma (PACG) are limited. This study evaluated IOP fluctuations following LPI across the PACD spectrum. Methods: This prospective observational comparative study was conducted at a tertiary eye-care centre. Patients with PACS, PAC, or PACG who underwent LPI were evaluated clinically and by gonioscopy. IOP was recorded before LPI, immediately after LPI, at 2 hours, and at 7 days. The primary outcome was change in IOP from baseline; secondary outcomes included mean IOP at each time point and the proportion of eyes with an IOP rise of ≥5 mmHg and ≥8 mmHg. Results: A total of 83 eyes of 79 patients were included in the final analysis. Baseline mean IOP was 13.97 ± 3.04 mmHg in PACS, 14.26 ± 4.57 mmHg in PAC, and 16.63 ± 6.48 mmHg in PACG (p = 0.081). Immediately after LPI, mean IOP was 14.29 ± 4.37, 12.37 ± 3.90, and 15.15 ± 5.35 mmHg, respectively (p = 0.151), and at 2 hours it was 13.53 ± 4.22, 12.68 ± 4.12, and 14.74 ± 5.22 mmHg (p = 0.357). At 7 days, mean IOP increased to 15.42 ± 4.97 mmHg in PACS, 16.33 ± 4.77 mmHg in PAC, and 22.00 ± 7.70 mmHg in PACG, with a statistically significant intergroup difference (p < 0.001). The mean change from baseline to day 7 was +1.45, +1.83, and +5.37 mmHg in PACS, PAC, and PACG, respectively. Clinically significant immediate IOP elevation was uncommon, with an IOP rise of ≥5 mm Hg reported in 6.0% of eyes and ≥8 mmHg in 1.2% of eyes in the study analysis. No vision-threatening complication due to acute IOP elevation was observed during follow-up. Conclusion: LPI was associated with relatively stable immediate and 2-hour IOP measurements across the PACD spectrum, with clinically significant acute IOP spikes being uncommon. PACG eyes demonstrated a significantly higher IOP at 7 days and a greater mean increase from baseline, which may reflect underlying trabecular dysfunction and chronic impairment of aqueous outflow rather than a direct delayed laser effect. Closer post-LPI IOP monitoring and additional IOP-lowering treatment may be required in eyes with established PACG.
Keywords	Primary angle-closure disease; PACS; PAC; PACG; laser peripheral iridotomy; intraocular pressure; IOP spike; glaucoma.
Field	Medical / Pharmacy
Published In	Volume 8, Issue 5, September-October 2026
Published On	2026-09-30

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International Journal For Multidisciplinary Research

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ive Evaluation of Intraocular Pressure Fluctuations Post Laser Peripheral Iridotomy in PACD spectrum

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