Laser Iridotomy for Aphakic Pupillary Block

In 6 patients with aphakic pupillary block, argon laser produced full thickness iridotomies that succeeded in restoring anterior chamber and intraocular pressure to normal. In one case, it was shown that location of iridotomy is important in determining whether or not iridotomy will succeed in relieving aphakic pupillary block. In 2 cases, pupillary block had resulted in shallowing of the anterior chamber without pressure elevation. Cases reported here show that continuous laser energy, such as from an argon laser, can produce a full thickness opening, in contrast to the short duration pulse of the ruby, which will destroy only pigmented structures without producing a full thickness iris opening. This need to produce some degree of spread of damage to unpigmented tissue elements in order to achieve an iris opening is a problem in phakic patients where injury to the lens must be avoided.