Dilated, miotic-resistant pupil and laser iridotomy in primary angle-closure glaucoma

Ophthalmologica. 1997;211(4):205-8. doi: 10.1159/000310790.


We analyzed 22 eyes with primary angle-closure glaucoma that underwent initial laser iridotomy to determine which factors could lead to subsequent trabeculectomy. Twenty-two eyes were divided into two groups: (1) the eyes in which intraocular pressure (IOP) could be controlled by iridotomy and/or topical medication (iridotomy success group, 15 eyes) and (2) the eyes that underwent trabeculectomy to control IOP in spite of a patent opening (iridotomy failure group, 7 eyes). The clinical variables between the two groups were analyzed. Age, sex, visual field defect, presenting IOP and cup/disk ratio were not significantly different between the iridotomy success and failure groups. However, presence of peripheral anterior synechiae (PAS) greater than 50% was found more frequently in the iridotomy failure group as compared with the iridotomy success group (4/7 vs. 1/15, p = 0.02). Dilated, miotic-resistant pupils were observed only in the iridotomy failure group (4/7 vs. 0/15, p = 0.004). PAS greater than 50% and dilated, fixed pupils were observed in these same cases (4 eyes). Our results suggest that laser iridotomy may not be helpful in cases with dilated and miotic-resistant pupils with formation of extensive PAS.

MeSH terms

  • Aged
  • Drug Resistance
  • Female
  • Glaucoma, Angle-Closure / physiopathology
  • Glaucoma, Angle-Closure / surgery*
  • Humans
  • Intraocular Pressure
  • Iris / surgery*
  • Laser Therapy*
  • Male
  • Middle Aged
  • Miotics / therapeutic use*
  • Pupil / drug effects*
  • Reoperation
  • Retrospective Studies
  • Trabeculectomy
  • Treatment Failure


  • Miotics