Selective laser trabeculoplasty combined with laser peripheral iridoplasty for angle-closure glaucoma

Abstract

Objective To investigate the safety and efficacy of selective laser trabeculoplasty combined with laser peripheral iridoplasty for primary angle-closure glaucoma.Methods Forty-two eyes of 31 patients with angle-closure glaucoma of 180° angle opened were enrolled in this study.The average preoperative intraocular pressure (IOP) and number of medications (NM) were (24.44±3.26) mmHg and (1.77±0.85),respectively.The trabecular meshwork (TM) of each eye can be observed about 180°,which was irradiated with a frequency doubled Q-switched Nd:YAG laser.Total of 70-80 laser spots were placed over 180° of the TM.Topical antiglaucoma drugs were given as the same as preoperative during the follow up period.Visual acuity,IOP,slit lamp examination,gonioseopy,and coefficient of outflow facility were regularly performed after laser surgery.Results At the end of 1 day,1 week,and 1,3,6,9,12 months of follow-up period,IOP of 42 eyes were 17.23±3.06 mmHg,18.15±3.15mmHg,19.82±3.22 mmHg,19.56±2.98 mmHg,19.01±3.14 mmHg,20.38±2.94mmHg,20.77±3.27 mmHg,respectively.Compared with baseline,there were statistically significant lOP decrease (P ＜ 0.01),and without obviously decrease of NM (P ＞ 0.05),during 1-12months postoperatively.Ciliary congestion and aqueous flare were disappearance without anti-inflammatory eye drops 1 week later.Coefficient of outflow facility were 0.13±0.09 和0.36±0.14 respectively at pretreatment and 3 months after SLT,difference was statistically significant (P =0.001).Conclusions Selective laser trabeculoplasty combined with laser peripheral iridoplasty for primary angle-closure glaucoma is effective and safe for angle-closure glaucoma,however,it is an essential prerequisite that 1/2 circle of angle of the anterior chamber is opened. Key words: Angle-closure glaucoma; Selective laser trabeculoplasty; Laser peripheral iridoplasty