Functional evaluation of an iridotomy in primary angle closure eyes

Objective To evaluate the functional efficacy of an iridotomy in primary angle closure (PAC) eyes by measuring IOP responses to provocative tests before and after iridotomy. Design Prospective cohort study. Subjects 50 consecutive adult patients, 40–60 years of age, having primary angle closure. Methods Clinical examination, perimetry, biometry and ultrasound biomicroscopy of the angle were done. A darkroom prone provocative test (DRPPT), a mydriatic test and a Valsalva maneuver were performed before and after the iridotomy. Main outcome measures IOP change in response to the provocative tests before and after iridotomy, and correlation with baseline parameters. Results IOP at baseline and after iridotomy was 14.4 ± 2.7 mmHg and 14.3 ± 2.6 mmHg, respectively ( p = 0.)83. There was no significant change on diurnal phasing before and after an iridotomy ( p = 0.)11. The mean IOP rise was 5.9 ± 3.7 mmHg on the DRPPT, 4.3 ± 3.5 mmHg on the Mydriatic test and 9.1 ± 4.9 mmHg on the Valsalva maneuver, and was reduced significantly to 3.2 ± 2.1 mmHg, 2.3 ± 1.8 and 6.4 ± 3.5, respectively( p