Surgical peripheral iridotomy (PI) may be a better bet than laser PI for patients with iris bombé and in young subjects with uveitis, a study in the British Journal of Ophthalmology reports.

New Zealand researchers found patients who had surgical PI had a longer survival rate than those who had the YAG laser PI procedure.

The retrospective study included 39 patients (52 eyes) with a history of uveitis who had either YAG (111 subjects) or surgical PI (20 subjects) at the Auckland District Health Board over an 11-year period.

The study defined PI failure as loss of patency or the recurrence of iris bombé.

Researchers reported human leukocyte antigen-B27 (HLA-B27) positive uveitis was the most common diagnosis (25.6%).

The median survival time for YAG PI was 70 days compared with 11 years for surgical PI. Investigators identified younger age at the time of the procedure and iris bombe as being higher risk factors for failure, and surgical PI was associated with a lower risk failure compared with the YAG approach. The study also reported glaucoma developed in 19 eyes (36.5%), of which 13 required glaucoma surgery. 

Betts TD, Sims JL, Bennett SL, Niederer RL. Outcome of peripheral iridotomy in subjects with uveitis. Br J Opthalmol. July 9, 2019. [Epub ahead of print].