Size Matters.

Abstract

To describe the ideal size of a laser iridotomy and to discuss its importance. Perspective. Articles in ophthalmology literature on this topic were reviewed, and commentary is provided based on the authors' experiences. An ideal laser iridotomy size is 200 µm or larger, especially in eyes with uveitis. The final size of an iridotomy must be confirmed after the effects of the pilocarpine has worn off and the pupil is not being constricted by light. A location of the iridotomy furthest from the lid margin may reduce the chances of dysphotopsias and thus allow for an adequate-sized iridotomy. An iridotomy of an ideal size is needed to reduce the pressure differential on both sides of the iris so as to be effective in eliminating pupillary block.