Tips and Tricks for In-Office Laser Peripheral Iridotomy

Nicholas R. Green, OD, MPH, FAAO, reviews best practices and clinical pearls for LPI at Optometry's Meeting 2026.

By
Sarah Fackler, managing editor, Optometric Management
June 17, 2026
5 min

Optometric Management

Objective:

To describe the advantages and best practices for in-office laser procedures, particularly laser peripheral iridotomy (LPI), as presented by Nicholas R. Green, OD, MPH, FAAO, at Optometry's Meeting 2026.

Approach:

Key Findings:

LPI is indicated for primary angle-closure glaucoma and related conditions.
Contraindications for LPI include secondary angle closure without pupillary block and neovascular glaucoma.
Reported complications include dysphotopsias, iris bleeding, and nonpatency of the iridotomy.

Interpretation:

The presentation highlights the importance of updated knowledge and skills in performing laser procedures for optometrists.

Limitations:

The article does not provide specific data on the long-term outcomes of LPI compared to other treatments, which may limit understanding of its effectiveness.
No disclosures from Dr. Green are mentioned, which may limit the understanding of potential biases.

Conclusion:

Incorporating laser procedures into optometric practice requires careful patient selection and adherence to best practices as emphasized by Dr. Green.