This systematic
review aimed to clarify the relationship between the location of laser peripheral iridotomy (LPI), a common procedure to prevent or treat angle-closure glaucoma, and the incidence of post-procedure visual disturbances known as dysphotopsias. Understanding this relationship is crucial due to the high frequency of LPIs performed and the significant impact dysphotopsia can have on vision and quality of life. Articles investigating the relationship between LPI location and dysphotopsia in at least five patients were identified via a literature search of OVID MEDLINE (1946-November 19, 2022) and EMBASE (1946-November 19, 2022). Non-comparative and non-English studies were excluded. Studies did not require a control group to be included. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system and Cochrane Risk of Bias 2 (RoB2) tool were used to appraise included studies. Our
review included three studies encompassing 1756 eyes from 878 patients. The location of LPI was grouped into superior (604 patients, 889 eyes), inferior (150 patients, 150 eyes), and nasal/temporal (443 patients, 717 eyes). The analysis showed no significant difference in the incidence of any new dysphotopsia types among the location groups post-LPI. Overall, the incidence of lines, ghost images, and blurring significantly increased after LPI, while halos and glare significantly decreased. In conclusion, the current literature suggests that the location of LPI has no significant relationship to the types and rates of dysphotopsia experienced thereafter. While there is a 2-3% risk of linear dysphotopsia after LPI regardless of location, LPI may also resolve pre-existing halos and glare.
摘要: 周边虹膜激光切开术 (LPI) 是预防或治疗闭角型青光眼的一种常见手术, 本综述旨在阐明周边虹膜激光切开术 (LPI) 选择的位置与术后视力障碍发生率之间的关系。由于 LPI 手术的高频率以及视力障碍对视力和生活质量的重要影响, 对其了解至关重要。通过对 OVID MEDLINE (1946 年至 2022 年 11 月 19 日) 和 EMBASE (1946 年至 2022 年 11 月 19 日) 数据库进行文献检索, 发现至少有五名患者的 LPI 位置与视力障碍之间关系的研究文章。非比较型研究和非英文研究被排除在外。纳入研究无需对照组。采用推荐、评估、发展和评价分级 (GRADE) 系统和 Cochrane Risk of Bias 2 (RoB2) 工具对纳入的研究质量进行评估。本综述包括三项研究, 涉及 878 名患者的1756只眼睛。LPI 的位置分为上侧 (604名患者, 889只眼) 、下侧 (150名患者, 150只眼) 和鼻/颞侧 (443名患者, 717只眼) 。分析结果表明, LPI 后各位置组的新发生的视力障碍类型发生率无明显差异。总体而言, LPI后线性视力障碍、黑影和视物模糊的发生率明显增加, 而光晕和眩光则明显减少。总之, 目前文献表明, LPI位置与术后出现的视力障碍类型和发生率没有相关性。无论在哪个位置, LPI后都有 2%-3% 的线性视力障碍风险, 但LPI 也可以解决之前存在的光晕和眩光问题。.