O efeito da iridectomia periférica em pacientes com glaucoma pigmentar

O efeito da iridectomia periférica em pacientes com glaucoma pigmentar


Vital Paulino Costa,
Sai Gandham,
Maura Smith,
George L. Spaeth


Arquivos Brasileiros de Oftalmologia

versão impressa ISSN 0004-2749versão On-line ISSN 1678-2925

Arq. Bras. Oftalmol. vol.57 no.1 São Paulo fev. 1994


The authors analyze the effects of peripheral iridectomy in patients with pigmentary glaucoma. Two studies were designed: the first, retrospective, compared patients with bilateral pigmentary glaucoma, in whom peripheral iridectomy had been performed in only one eye. The second, a prospective study, compared eyes that had undergone iridectomy to randomly selected control eyes of patients with pigmentary glaucoma. The retrospective study showed that the iridectomy changed the configuration of the midperipheral iris, and reduced the pigmentation of the trabecular meshwork and the Krukenberg spindle. The prospective study, using a computerized method of analyzing the anterior segment, demonstrated that the iridectomy shallowed the angle. For the first time, we showed that peripheral iridectomies may change the angle configuration and, at the same lime, may decrease the pigment dispersion. Further research is required to determine the effects on intraocular pressure and progression of optic nerve damage.


1 FARRAR SM, SHIELDS MB, MILLER KN, STOUP CM. - Risk factors for the development and severity of glaucoma in the pigment dispersion syndrome. Am J Ophthalmol, 108:223-229, 1989.
2 EPSTEIN DL. - Pigment dispersion syndrome and glaucoma. Ann Ophthalmol, 11:917-918, 1979.
3 STEINBERGER D, RITCH R, LIEBMANN JM, LUTUFO D. - Prevalence of pigment dispersion syndrome in a screening sample. Invest Ophthalmol Vis Sci. (Suppl) 33:732, 1992.
4 GRANT WM. - Experimental aqueous perfusion in enucleated human eyes. Arch Ophthalmol, 69:783-801, 1963.
5 RICHARDSON TM, HUTCHINSON BT, GRANT WM. - The outflow tract in pigmentary glaucoma: a light and electron microscopy study. Arch Ophthalmol, 95:1015-1025, 1977.
6 CAMPBELL DG. - Pigmentary dispersion and glaucoma: a new theory. Arch Ophthalmol. 97:1667-1672, 1979.
7 FARRAR SM, SHIELDS MB. - Current concepts in pigmentary glaucoma. Surv Ophthalmol, 37:233-252, 1993.
8 SPAETH GL. - The normal development of the human anterior chamber angle: a new system of descriptive grading. Trans Ophthalmol Soc UK, 91:709-721, 1971.
9 CAMPBELL DG, JEFFERY CP. - Pigmentary dispersion in the human eye, SEM. Scanning Electron Microscopy. O'Hare, SEM Inc, 1979, pp 329-334.
10 KAMPIK A, GREEN WR, QUIGLEY HA, PIERCE LH. - Scanning and transmission electron microscopic studies of Iwo cases of pigment dispersion syndrome. Am J Ophthalmol, 91:573-587, 1981.
11 KARICKHOFF KR. - Pigm dispersion syndrome and pigmentary glaucoma: a new mechanism concept, a new treatment and a new technique. Ophthalmic Surg,, 1992.
12 CAMPBELL DG. Comunicação pessoal, 1992.