The effect of anterior chamber paracentesis for treating acute attack of angle-closure glaucoma in different period

Abstract

Objective To evaluate the effect of anterior chamber paracentesis for treating acute attack of angle-closure glaucoma in different period.Methods The 60 cases of primary angle-closure glaucoma in the first acute attacking period were divided into three groups:group A,n =20,operation time within 24 hours after the onset,group B,n =20,operation time in one to three days after the onset,group C,n =20,operation time in four to seven days after the onset.After paracentesis of anterior chamber,medications were applied to control intraocular pressure (IOP).The medical records of pain,IOP,vision,anterior chamber angle in three groups were comparatively analyzed.Results Tne decrease of IOP had significant different between the three groups.The IOP drop value in group A was larger than that in group B (t =3.77,P =0.000),which was higher than that in group C (t =2.85,P =0.01).The differences were statistically significant in degrees of pain relief,vision improvement,opening of anterior chamber angle among the three groups.The results of group A were better than group B (x2 =5.63,P =0.03 ;x2 =13.08,P =0.00 ;x2=10.99,P =0.00).The results of group B were better than group C (x2 =3.87,P =0.04 ;x2 =6.05,P =0.04 ;x2 =4.80,P =0.03).The differences were statistically significant in the number of the patients who underwent YAG laser peripheral iridotomy in those three groups,the number in group A was larger than group B (x2 =10.99,P=0.00),the number in group B was larger than group C (x2 =4.80,P =0.03).Conclusion Paracentesis of anterior chamber on acute attack of angle closure glaucoma can effectively relieve pain in early period,control intraocular pressure,restore visual function and can decrease or even avoid the possibilities of glaucoma filtering operation.Anterior chamber paracentesis at more than 3 days after attack will not reduce the possibility of filtering operation. Key words: Glaucoma, angle-closure ; Attack, acute ; Pressure, intraocular; Paracentesis, anterior chamber