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Abstract #26817 Published in IGR 12-3
Reasonable emergency surgical method of the sustained high intraocular pressure of acute angle-closure glaucoma
Cai S-J; Wang L-B; Huang J; Chen S-YInternational Journal of Ophthalmology 2010; 10: 867-870
AIM: To find a more rational surgical method of the sustained high intraocular pressure (SHIOP) of acute angle-closure glaucoma, a contrast study on selective peripheral iridectomy and trabeculectomy under the SHIOP was completed. METHODS: A total of 54 patients (54 eyes) whose intraocular pressure (IOP) were still higher than 40mmHg after maximum dose of drug medicine were divided into 2 groups according to their duration of high intraocular pressure(DOHIOP): In Group A, all patients with first-episode, whose DOHIOP was no longer than 48 hours, peripheral iridectomy (20 eyes) was adopted; ln Group B, the DOHIOP was longer than 48h, trabeculectomy (34 eyes) was implemented. RESULTS: The patients were followed up for 6 to 18 months (an average of 12.3 months) after operation. The success rate of operation was 85.0% after peripheral iridectomy and 82.4% after trabeculectomy (P>0.05); The postoperative IOP in the peripheral iridectomy group was 17.98 (plus or minus) 4.25mmHg, and 17.12 (plus or minus) 4. 65mmHg in the trabeculectomy group (P>0.05). The postoperative visual acuity in Group A and in Group B was 0.51 (plus or minus) 0.09 and 0.3 (plus or minus) 0.07 respectively (P<0.05). The opening rate of chamber angle of Group A were higher than that of Group B (P<0.05); the pupils of 18 eyes in Group A (90%) were adjustable, while 13 eyes (38.2%) in Group B (P<0.01); compared with Group B, Group A had few postoperative complications, mild inflammation of anterior segment, no wound leakage, choroidal detachment or malignant glaucoma (P<0.05). CONCLUSION: Reasonable emergency surgical method for the SHIOP in the acute attack of acute angle-closure glaucoma: when the DOHIOP is no more than 48 hours, in the first attack, peripheral iridectomy should be selected, which is a fast, convenient, safe and effective operation with few complications, and is able to maintain better visual acuity and adjustable pupils; while more than once attack, and the DOHIOP is longer than 48 hours, trebculectomy with MMC and sclera lamella removable suture should be used to control the intraocular pressure and save the visual acuity.LA: Chinese
S.-J. Cai. Department of Ophthalmology, People's Hospital of Kunshan, Kunshan 215300, Jiangsu Province, China. csjman@126.com
Classification:
9.3.1 Acute primary angle closure glaucoma (pupillary block) (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)
12.7 Surgical iridectomy (Part of: 12 Surgical treatment)
12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
