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Abstract #26417 Published in IGR 12-3
Laser Peripheral Iridotomy With and Without Iridoplasty for Primary Angle-Closure Glaucoma: 1-Year Results of a Randomized Pilot Study
Sun X; Liang YB; Wang NL; Fan SJ; Sun LP; Li SZ; Liu WRAmerican Journal of Ophthalmology 2010; 150: 68-73
Purpose: To compare the efficacy and safety of laser peripheral iridotomy with or without laser peripheral iridoplasty in the treatment of eyes with synechial primary angle-closure or primary angle-closure glaucoma. Design: Randomized, controlled clinical trial. Methods: Consecutive patients older than 40 years with synechial primary angle-closure or primary angle closure glaucoma were recruited. Eligible patients were randomized to 1 of 2 treatment options, iridotomy or iridotomy plus iridoplasty, and were followed up for 1 year. Main outcome measures were intraocular pressure (IOP), peripheral anterior synechiae, corneal endothelial cell count, and complications. Results: Seventy-seven eyes (77 patients) were randomized to the iridotomy group, and 81 eyes (81 patients) were randomized to the iridotomy plus iridoplasty group. Sixty-one patients (79.2%) in the iridotomy and 65 patients (80.2%) from the iridotomy plus iridoplasty groups completed 1 year of follow-up. There were no significant differences between the groups in the baseline data. IOP was reduced from 24.66 (plus or minus) 13.76 mm Hg to 19.03 (plus or minus) 6.21 mm Hg in the iridotomy group (P < .001) and from 27.96 (plus or minus) 13.06 mm Hg to 20.45 (plus or minus) 7.26 mm Hg in the iridotomy plus iridoplasty group (P < .001). Extent of peripheral anterior synechiae was decreased by 1 more clock-hour after iridoplasty compared with that after iridotomy in the iridotomy plus iridoplasty group (P < .001). There was no significant difference in IOP, medications, need for surgery, or visual function between groups at the 1-year visit. Conclusions: In eyes with synechial primary angle-closure or primary angle-closure glaucoma, both iridotomy alone or combined with iridoplasty provide a significant and equivalent reduction in IOP. There is also a possible reduction in peripheral anterior synechiae, more so in the iridoplasty group.
N.L. Wang. Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China. wningli@vip.163.com
Classification:
12.2 Laser iridotomy (Part of: 12 Surgical treatment)
12.3 Laser iridoplasty (Part of: 12 Surgical treatment)
9.3.5 Primary angle closure (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)
9.3.2 Chronic primary angle closure glaucoma (pupillary block) (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)
