Cataract progression after Nd-YAG laser iridotomy in primary angle-closure suspect eyes
Reviewed by Jonathan Chan

A total of 889 of eligible bilateral primary angle-closure suspect (PACS) patients were recruited from the Zhongshan Angle Closure Prevention Trial. One randomly selected eye received laser peripheral iridotomy (LPI), while the fellow remained untreated. Cataract was graded by the Lens Opacity Classification System III, and the progression was defined as an increase in grade by at least two units in any category or cataract surgery. At 72 months, laser treated eyes had slightly higher average nuclear grades (p<0.001). There was no difference between eyes for predefined cataract progression or cataract surgery (1% for both groups). LPI-treated eyes had a 10% higher risk of progression over six years (HR=1.10) but not significant statistically. Visual acuity was similar in the treated and untreated eyes at 72 months (p=0.43). The authors concluded that lenses were graded on average slightly opaquer in the laser-treated eyes, but prophylactic LPI did not cause significant cataract progression. LPI treatment of PACS does not increase the risk of developing clinically significant cataract worsening over the observed time frame.

Cataract progression after Nd:YAG laser iridotomy in primary angle-closure suspect eyes.
Chang DST, Jiang Y, Kim JA, et al.
BRITISH JOURNAL OF OPHTHALMOLOGY
2023;107(9):1264–8.