Laser peripheral iridotomy has recently been suggested as a treatment, and perhaps a cure, for pigment dispersion syndrome and pigmentary glaucoma.1 I report herein a case in which a peripheral iridotomy had no apparent effect on iris configuration or intraocular pressure (IOP).
Report of a Case.
A 38-year-old white woman presented with a history of bilateral pigment dispersion and elevated IOP despite treatment with 0.5% levobunolol hydrochloride twice daily in both eyes. Visual acuity was 20/20 OU. The refraction was -2.50 +1.50 X4 ODand -2.50 +1.25 X2OS. Slit-lamp examination was remarkable for Krukenberg spindles in both eyes (right eye greater than left eye), and multiple midperipheral radial iris transillumination defects (right eye greater than left eye). Intraocular pressure was 27 mm Hg in the right eye and 28 mm Hg in the left. Gonioscopy revealed homogeneous dense pigmentation of the trabecular meshwork and posterior bowing of the peripheral iris
Jampel HD. Lack of Effect of Peripheral Laser Iridotomy in Pigment Dispersion Syndrome. Arch Ophthalmol. 1993;111(12):1606. doi:10.1001/archopht.1993.01090120028009