Miotics or mydriatics for atony of the ciliary muscle with delayed re-formation of anterior chamber after cataract extraction with complete iridectomy.
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One half of 20 patients (40 eyes) with ocular hypertension and occludable angles, some with peripheral anterior synechiae, were randomly assigned for treatment by Nd:YAG laser iridotomy. Pre-randomization patients required pilocarpine to maintain normal intraocular tension. Following laser treatment, all eyes were followed a minimum of 12 months (mean of 24). In the nonlaser-treated group, pilocarpine alone controlled intraocular pressure. In the laser treated group, eyes without peripheral anterior synechiae required fewer medications to maintain normal pressures while eyes with peripheral anterior synechiae required more. Although relief of pupillary block by laser iridotomy can facilitate management of this group of patients, preexisting peripheral anterior synechiae may be associated with greater therapeutic requirements following laser treatment.
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