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Searches were performed for studies that either compared corneal endothelial cell density\/count, corneal thickness and morphology pre\u2010 and postiridotomy, or evaluated the postiridotomy development of corneal decompensation. There were 26 eligible studies. Our review shows that the effect of laser iridotomy on the corneal endothelium has been investigated with varying results. Although it has been demonstrated to be a relatively safe procedure, there is still the potential long\u2010term risk of corneal decompensation, for which a corneal transplantation may be indicated eventually. The longest interval between laser iridotomy and corneal decompensation reported was 8\u00a0years. Mechanisms proposed for endothelial damage include direct focal injury, thermal damage, mechanical shock waves, iris pigment dispersion, transient rise in intraocular pressure, inflammation, turbulent aqueous flow, time\u2010dependent shear stress on endothelium, chronic breakdown of blood\u2013aqueous barrier and damage from bubbles that settled onto the endothelium. Inherent risk factors identified were iridotrabecular contact, current or prior acute angle closure, pigmented irides, small iris\u2010to\u2010endothelium distance, pre\u2010existing endothelial disease and diabetes. Intervention\u2010related risk factors include laser type, delivery and quantity. The significance of the risk factors and their direct association with the development of corneal decompensation remain to be determined. Understanding these risk factors may allow physicians to counsel their patients better. They may offer opportunities for preventive strategies, allowing us to ensure that a procedure performed to prevent disease progression and visual loss does not cause further morbidity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aos.12367","type":"journal-article","created":{"date-parts":[[2014,2,17]],"date-time":"2014-02-17T11:44:46Z","timestamp":1392637486000},"page":"604-616","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":48,"title":["Laser iridotomy and the corneal endothelium: a systemic review"],"prefix":"10.1111","volume":"92","author":[{"given":"Priscilla X.","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Ophthalmology National University Health System Singapore City Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor T. 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