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Abstract

We thank the authors for their interest in our work.1Narayanaswamy A. Baskaran M. Perera S.A. et al.Argon laser peripheral iridoplasty for primary angle-closure glaucoma: a randomized controlled trial.Ophthalmology. 2016; 123: 514-521Abstract Full Text Full Text PDF PubMed Scopus (27) Google Scholar At the outset, we would like to apologize for the error in the Clinical Trials identifier number. The trial is registered at http://clinicaltrials.gov, and the correct ClinicalTrials.gov Identifier is NCT00980473. The primary aim of our trial was to assess the effectiveness of laser iridoplasty in eyes with residual angle closure and high intraocular pressure after laser peripheral iridotomy, a relatively common clinical scenario. Huang's and Zhang's recommendation of identifying the submechanism of angle closure and analyzing the treatment response of iridoplasty is desirable, in reality, several mechanisms may coexist in eyes with angle closure. Although Wang et al2Wang N. Wu H. Fan Z. Primary angle closure glaucoma in Chinese and Western populations.Chin Med J (Engl). 2002; 115: 1706-1715PubMed Google Scholar have classified angle closure into pupil block, non–pupil block, and multiple mechanisms, they still recommend laser iridotomy as the first line of treatment for all 3 subgroups, which reiterates our point that mechanisms coexist. Our current understanding of angle closure mechanisms has improved with the use of novel imaging devices. In our study, we used ultrasound biomicroscopy to distinguish eyes with plateau iris, an important non–pupil block mechanism in angle closure.3Nongpiur M.E. Ku J.Y. Aung T. Angle closure glaucoma: a mechanistic review.Curr Opin Ophthalmol. 2011; 22: 96-101Crossref PubMed Scopus (148) Google Scholar However, our multivariate analysis found that this factor did not influence the final outcome of iridoplasty. The efficacy of iridoplasty in specific submechanisms of angle closure is potentially interesting to explore, and we encourage other groups to embark on further randomized controlled trials to evaluate this question. Re: Narayanaswamy et al.: Argon laser peripheral iridoplasty for primary angle-closure glaucoma: a randomized controlled trial (Ophthalmology 2016;123:514-21)OphthalmologyVol. 123Issue 8PreviewWe read with interest the article by Narayanaswamy et al.1 In this randomized controlled trial, the authors found that argon laser peripheral iridoplasty was less effective in reducing intraocular pressure than prostaglandin analog therapy in eyes with persistent appositional angle closure. In the study, the authors reported that the trial was registered with ClinicalTrials.gov (identifier, NCT00607685 ). However, the identifier ( NCT00607685 ) links to another trial titled “5FU vs 5FU With Viscoelastic Formulation for the Prevention of Scarring Post-trabeculectomy.” In addition, according to Wang et al,2 primary angle-closure glaucoma in a Chinese population can be classified into 3 types depending on the mechanism of angle closure: (1) multimechanism, (2) pupillary block, and (3) nonpupillary blocking. Full-Text PDF