Limited argon laser peripheral iridoplasty as immediate treatment for an acute attack of primary angle closure glaucoma: a preliminary study.
OBJECTIVE
To study the efficacy and safety of limited (180 degrees) argon laser peripheral iridoplasty (ALPI) as a first-line treatment for acute primary angle closure glaucoma (PACG) without the use of systemic anti-glaucomatous medications.


METHODS
Ten consecutive patients with PACG were recruited into the study. Each patient received topical pilocarpine (4%) and timolol (0.5%), and immediate limited ALPI as primary treatment. The intraocular pressures at 15, 30 and 60 min after ALPI were documented by Goldmann applanation tonometry.


RESULTS
The mean intraocular pressure (IOP) of this group of patients was reduced from 57.9 +/- 10.6 mmHg to 39.0 +/- 10.9 mmHg at 15 min, 28.3 +/- 9.1 mmHg at 30 min and 20.4 +/- 9.0 mmHg at 60 min after ALPI. No complications were encountered. In 8 of the 10 patients the corneal oedema cleared 1 h after ALPI. In the remaining 2 patients the corneal oedema cleared 2 h after ALPI.


CONCLUSIONS
Immediate limited ALPI, without adjunctive systemic anti-glaucomatous medications, appeared to be effective and safe in controlling the IOP in treating acute PACG with a duration of attack < or = 48 h. It may be as effective as 360 degrees ALPI, and therefore has a role in those patients in whom 360 degrees treatment is not possible.
Prince of Wales Hospital, Department of Ophthalmology & Visual Sciences, Chinese University of Hong Kong, Shatin, N.T. jsmlai@netvigator.com
J S
JS
Lai
C C
CC
Tham
D S
DS
Lam
D000208:Acute Disease; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D007498:Iris / Q000601:surgery*; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010277:Parasympathomimetics / Q000627:therapeutic use; D010862:Pilocarpine / Q000627:therapeutic use; D011229:Preanesthetic Medication; D013997:Time Factors; D013999:Timolol / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D010277:Parasympathomimetics; D010862:Pilocarpine; D013999:Timolol