Clinical Sciences |

Anterior Chamber Bleeding After Laser Peripheral Iridotomy

Shani Golan, MD; Hani Levkovitch-Verbin, MD, MPA; Gabi Shemesh, MD; Shimon Kurtz, MD
JAMA Ophthalmol. 2013;131(5):626-629. doi:10.1001/jamaophthalmol.2013.1642.
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Importance To our knowledge, this is the first study to describe the correlation of anterior chamber bleeding after laser peripheral iridotomy (LPI) and antiplatelet therapy.

Objective To determine the incidence and amount of anterior chamber bleeding after laser peripheral iridotomy in patients whose condition is suggestive of primary angle-closure glaucoma (PACS) who continued their antiplatelet or anticoagulant treatment before undergoing LPI compared with when they discontinued treatment.

Design and Setting A prospective controlled trial.

Patients Patients with suspected bilateral primary angle-closure and no other ocular disease who take antiplatelet or anticoagulant medications regularly (from January 2010-October 2011) were enrolled.

Main Outcome and Measure The incidence of anterior chamber bleeding with and without antiplatelet and anticoagulant therapy.

Results A total of 104 patients (208 eyes) participated in the study. Thirty-six eyes (34.6%) in the treated and untreated arms bled. The amount of bleeding did not differ significantly when the patient was on or off antiplatelet or anticoagulant treatment, nor did the immediate postprocedure mean intraocular pressure (P = .13). The type of antiplatelet or anticoagulant, total laser energy, age, sex, or color of irides were not risk factors for increased bleeding (P = .156 for all parameters).

Conclusions No indication was noted for discontinuing these medications before a high-powered pulsed laser peripheral iridotomy.

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