Laser Peripheral Iridotomy With and Without Iridoplasty for Primary Angle-Closure Glaucoma: 1-Year Results of a Randomized Pilot Study - 19/08/11
, Su Jie Fan b, Lan Ping Sun b, Si Zhen Li a, Wen Ru Liu b
Inquiries to Ning Li Wang, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, and the Beijing Ophthalmology & Visual Science Key Laboratory, No. 1 Dong Jiao Min Xiang Street, Dongcheng District, Beijing, People's Republic of ChinaRésumé |
Purpose |
To compare the efficacy and safety of laser peripheral iridotomy with or without laser peripheral iridoplasty in the treatment of eyes with synechial primary angle-closure or primary angle-closure glaucoma.
Design |
Randomized, controlled clinical trial.
Methods |
Consecutive patients older than 40 years with synechial primary angle-closure or primary angle closure glaucoma were recruited. Eligible patients were randomized to 1 of 2 treatment options, iridotomy or iridotomy plus iridoplasty, and were followed up for 1 year. Main outcome measures were intraocular pressure (IOP), peripheral anterior synechiae, corneal endothelial cell count, and complications.
Results |
Seventy-seven eyes (77 patients) were randomized to the iridotomy group, and 81 eyes (81 patients) were randomized to the iridotomy plus iridoplasty group. Sixty-one patients (79.2%) in the iridotomy and 65 patients (80.2%) from the iridotomy plus iridoplasty groups completed 1 year of follow-up. There were no significant differences between the groups in the baseline data. IOP was reduced from 24.66 ± 13.76 mm Hg to 19.03 ± 6.21 mm Hg in the iridotomy group (P < .001) and from 27.96 ± 13.06 mm Hg to 20.45 ± 7.26 mm Hg in the iridotomy plus iridoplasty group (P < .001). Extent of peripheral anterior synechiae was decreased by 1 more clock-hour after iridoplasty compared with that after iridotomy in the iridotomy plus iridoplasty group (P < .001). There was no significant difference in IOP, medications, need for surgery, or visual function between groups at the 1-year visit.
Conclusions |
In eyes with synechial primary angle-closure or primary angle-closure glaucoma, both iridotomy alone or combined with iridoplasty provide a significant and equivalent reduction in IOP. There is also a possible reduction in peripheral anterior synechiae, more so in the iridoplasty group.
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Vol 150 - N° 1
P. 68-73 - juillet 2010 Retour au numéro
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