Bah humbug -- I had a beautifully written up reply and it just poofed. My computer has been acting strangely.

So I don't have a link to the article because Dr. Conner cut and pasted it into my email. If you google the title -- most of the sites you have to pay for the article. So here it is pasted.

Am J Ophthalmol. 2014 May;157(5):929-35. doi: 10.1016/j.ajo.2014.02.010. Epub
2014 Feb 14.

Dysphotopsia after temporal versus superior laser peripheral iridotomy: a
prospective randomized paired eye trial.

Vera V(1), Naqi A(1), Belovay GW(1), Varma DK(2), Ahmed II(3).

Author information:
(1)University of Toronto, Department of Ophthalmology and Vision Sciences,
Toronto, Ontario, Canada. (2)University of Toronto, Department of Ophthalmology
and Vision Sciences, Toronto, Ontario, Canada; Trillium Health Partners,
Mississauga, Ontario, Canada; Credit Valley EyeCare, Mississauga, Ontario,
Canada. (3)University of Toronto, Department of Ophthalmology and Vision
Sciences, Toronto, Ontario, Canada; Trillium Health Partners, Mississauga,
Ontario, Canada; Credit Valley EyeCare, Mississauga, Ontario, Canada. Electronic
address: ike.ahmed@utoronto.ca.

Comment in
Am J Ophthalmol. 2014 Oct;158(4):849-50.
Am J Ophthalmol. 2014 Oct;158(4):850.

PURPOSE: To determine if the location of neodymium:yttrium-aluminum-garnet laser
peripheral iridotomy (LPI) is related to the occurrence of postoperative visual
dysphotopsia.
DESIGN: Randomized, prospective, single-masked, paired-eye comparative clinical
trial.
METHODS: setting: Private subspecialty clinic in Mississauga, Canada. study
population: Patients with primary angle closure or primary angle-closure suspects
were recruited and randomized to receive LPI temporally in one eye and superiorly
in the other. Patients were masked to the location of treatment in each eye.
intervention: Temporal or superior LPI. main outcome measures: Occurrence of
new-onset linear dysphotopsia. Other visual disturbances also were assessed using
a questionnaire before and 1 month after intervention. Secondary outcome measures
included eyelid position, laser parameters, and any intraoperative complications.
RESULTS: A total of 208 patients were recruited to the study, of which 169 (84%)
completed it. New-onset linear dysphotopsia was reported in 18 (10.7%) eyes with
superior LPI versus 4 (2.4%) eyes with temporal LPI (P = .002). Eleven eyes
(6.5%) with superior LPI reported linear dysphotopsia despite complete eyelid
coverage of the iridotomy. No significant differences were found with other
visual disturbances between them. There was more pain experienced by the temporal
LPI (2.8 ± 2.2 vs 2.1 ± 2.0; P = .001), despite no difference in laser energy or
number of shots. Intraoperative rates of hemorrhage were similar (8.9% vs 10.1%;
P = .71).
CONCLUSIONS: Temporal placement of LPI is safe and was found to be less likely to
result in linear dysphotopsia as compared with superior placement. Temporal iris
therefore may be considered a preferred location for LPI.

Copyright © 2014 Elsevier Inc. All rights reserved.

DOI: 10.1016/j.ajo.2014.02.010
PMID: 24531024 [PubMed - indexed for MEDLINE]

Also Glaucoma Research Foundation recommended this article: http://www.glaucoma.org/treatment/laser-iridotomy-10-commonly-asked-questions.php

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