Abstract:AIM: To evaluate the effect of laser peripheral iridoplasty(LPIP)to treat acute angle-closure glaucoma(AACG)which could not controlled by drugs and with persistent ocular hypertension.
METHODS: Totally 67 patients(69 eyes)with AACG were performed LPIP when intraocular pressure(IOP)was still over 30mmHg after the medicine therapy for 3-6 hours. Visual acuity and intraocular pressure were under detection before laser treatment and 30 minutes, 60 minutes and 2 hours after laser treatment. We measured the anterior chamber depth, width of angle, iris thickness with ultrasound biomicroscope(UBM). Dynamic gonioscopy was used to evaluate the degree of peripheral anterior synechia(PAS).
RESULTS: Angle open distance(AOD)after iridoplasty was increased(P<0.01). Trabecular-iris angle(TIA)was widen(P<0.01)and the extents of PAS were reduced in some cases. IOP reduced at different levels in different time after laser treatment. The mean IOP before acute attack was(53.81±10.22)mmHg. The mean IOP were(33.81±9.22)mmHg,(21.93±7.19)mmHg and(15.16±3.07)mmHg at 30 minutes, 60 minutes and 2 hours after laser treatment respectively(F=151.79, P<0.01). Visual acuity increased in all patients.
CONCLUSION: LPIP can deepen peripheral anterior chamber, increase the angle access and lower the IOP immediately. It is an important ongoing adjuvant treatment, which can reduce the patients suffering by lowering the IOP quickly, reduce the damage of visual function caused by long-term high intraocular pressure, avoid side effect of the drugs, and can improve the prognosis.
