Therapeutic options for narrow angle glaucoma

Abstract

AbstractPurpose To explain into detail the different therapeutic options present today for the treatment of narrow angles with and without glaucoma. Since not much is understood yet from narrow angle glaucoma; for instance why do some patients develop acute glaucoma and others don't?Methods Patients files of patients with narrow angles (classified by Visante OCT readings with an angle depth of less than 10°) were retrospectively investigated and subdivided into different groups based on the treatment they received. The first group received a bilateral Argon laser iridoplasty followed a bilateral yag iridotomy; whereas the second group of patients received a primary phacoemulsification. Primary outcome was the intraocular pressure, secondary outcome the effect on the Visante OCT and thereby the influence of the angle structure on progression of glaucoma.Results Both methods same to be effective in lowering the intraocular pressure. Of great importance is the selection of patients. Patients with a huge lens rise will obviously benefit more from a phacoemulsification, whereas hypermetropic patients will have a sufficient effect from the Argon‐Yag combination. Complications, repeatability, effectiveness of the therapies will be further compared in a prospective trial.Conclusion Both methods same to be effective in lowering the intraocular pressure. Randomized, prospective clinical trials are further necessary to solve this horrific type of narrow angle glaucoma.