Observe the clinical effect of acute attack of primary angle-closure glaucoma treated by paracentesis of anterior chamber and laser peripheral iridoplasty

Abstract

Objective To evaluate the practicability and safety between paracentesis of anterior chamber and laser peripheral iridoplasty as an initial treatment for acute attack of primary angle-closure glaucoma. Methods Fifty-five eyes (52 cases) with acute primary angle-closure glaucoma were divided into 2 groups.Group A (27 eyes) was treated with paracentesis of anterior chamber.Another group (28 eyes) was treated with laser peripheral iridoplasty.The post-treatment clinical data including the time of intraocular pressure (IOP) decreased to 21mmHg (lmmHg=0.133KPa),the angle of anterior chamber and the complications were observed.Results The IOP was reduced (12.7±3.4)mmHg,(13.6±5.8)mmHg,(14.2±4.4)mmHg,(19.6±5.2)mmHg,(18.3±4.5)mmHg,(19.7±3.1)mmHg,(17.5±5.6)mmHg at 30mins,lhr,2hrs,3hrs,4hrs,6hrs,12hrs after paracentesis of anterior chamber,respectively.The IOP of laser group were reduced (44.3±4.2)mmHg,(35.6±4.7)mmHg,(24.3±5.2)mmHg,(21.2±4.3)mmHg,(19.5±3.2)mmHg,(20.1±2.7)mmHg,(18.6±4.8)mmHg at the same time after treatment,respectively.There were statistical differences between the two groups in the IOP reduction at 30mins,lh and 2h (t =30.601,15.482,7.762; P ＜0.01).There were no significant differences between the two groups in the scope of opening anterior chamber angle (x2=0.559,P ＞0.05).The complications were inflammatory reaction in the anterior chamber and cilio-choroidal detachment.There were no complications such as intraocular infection and massive hemorrhage in the epichoroidal space. Conclusions The time of IOP decreasing is slower,and the inflammatory reaction in anterior chamber is gravely when using laser peripheral iridoplasty in treating acute attack of primary angle-closure glaucoma patients.The IOP decrease quickly and safely with the paracentesis of anterior chamber.And there are no grave complications.The paraccntesis of anterior chamber can be applied as an initial treatment for acute attack of primary angle-closure glaucoma. Key words: Pamcentesis of anterior chamber; Laser peripheral iridoplasty; Primary angle-closure glaucoma; Acute episode