Results of 233 peripheral iridectomies for narrow-angle glaucoma

1. 1. In 233 eyes, control of angle-closure glaucoma was achieved with peripheral iridectomy in 92.5% of acute cases, 69.2% without and 23.3% with medicine; in 88.2% of chronic cases, 58.8% without and 29.4% with medicine; and in 100% of prophylactic cases, all without medicine. From these results it appears that peripheral iridectomy is very effective in controlling angle-closure glaucoma. 2. 2. Visual acuity in the period of followup subsequent to peripheral iridectomy was maintained within one line of preoperative acuity on the Snellen chart in 81% of the eyes. Nineteen percent had a loss of two lines or greater, although most of these appeared due to development of cataracts not associated immediately in time with the peripheral iridectomy. Thus, it appears that peripheral iridectomy is a benign procedure. 3. 3. Preoperative facilities of outflow correlate to a degree with the results to be expected from a peripheral iridectomy. With a facility of outflow greater than 0.15, the operation was successful without exception, and with facilities between 0.11 and 0.15, it was successful in approximately two-thirds of the cases. A significant difference appeared between acute and chronic cases with a facility of outflow less than 0.11, acute cases having a success rate of 60%, whereas chronic cases had only 22%. From these data, it appears that peripheral iridectomy frequently has a favorable outcome, except in chronic cases with a low facility of outflow, and that the procedure should be considered even in these cases. 4. 4. Our results indicate that for control of all forms of angle-closure glaucoma, peripheral iridectomy should be carefully considered as the initial operation, as suggested by Forbes and Becker.¹⁰.