Nd: yag laser iridotomy in Shaffer-Etienne grade 1 and 2: angle widening in our case studies

Aim: To obtain widening of a potentially occludable angle, in according to Kanski’s indications, through preventive Nd:Yag laser iridotomy. The observational study was performed by using gonioscopy for the selection and follow-up of 1165 treated eyes and exploiting Shaffer-Etienne gonioscopic classification as a quality/quantity test of the angle recession. Methods: Between September 2000 and July 2012, 586 patients were selected at the Outpatients’ Ophthalmological Clinic of the Policlinico Umberto I of Rome in order to undergo Nd:Yag laser iridotomy. A Goldmann type contact lens, Q-switched mode, 2–3 defocus, and 7–9 mJ intensity with 2–3 impulse discharges were used for surgery. Results: From as early as the first week, a whole 360° angle widening were evident in the patients, thus showing the success of Nd:Yag laser iridotomy in solving relative pupil block. The angle remained narrow by 270° in 14 eyes only, despite repetitions of further treatment with laser iridotomy in a different part of the iris, twice in 10 eyes and three times in 4 eyes. Conclusion: Nd:Yag laser iridotomy revealed itself as being a safe and effective treatment in widening those critical Shaffer-Etienne grade 1 and 2 potentially occludable angles.