Laser peripheral iridoplasty as initial treatment of acute attack of primary angle-closure: a long-term follow-up study.
OBJECTIVE
To study the long-term clinical course and complications of patients with acute primary angle-closure treated with immediate laser peripheral iridoplasty followed by laser peripheral iridotomy.


METHODS
Consecutive patients with acute primary angle closure treated with immediate laser peripheral iridoplasty, followed by laser peripheral iridotomy, at the Prince of Wales Hospital from July 1997 through January 2000 were followed up to document the clinical course of their disease and any complications from the laser treatment. Visual acuity, intraocular pressure, gonioscopic findings, corneal and lens clarity, iris appearance, pupillary reaction, and progression of glaucomatous optic neuropathy were evaluated.


RESULTS
Thirty eyes of 29 Chinese patients with acute primary angle closure treated initially with either argon or diode laser peripheral iridoplasty were recruited. The mean follow-up period was 33.0 +/- 9.3 months. Twenty-one eyes (70%) had no further attack and maintained normal intraocular pressure without medications, and 9 eyes (30%) developed chronic angle-closure glaucoma with peripheral anterior synechiae. All eyes had pigmented laser marks on the peripheral iris, but none had peripheral corneal burn.


CONCLUSIONS
Long-term follow-up data indicated that 30% of Chinese eyes with acute primary angle closure successfully treated with immediate laser peripheral iridoplasty followed by laser peripheral iridotomy developed peripheral anterior synechiae and an increase in intraocular pressure. There were minimal long-term complications on the cornea and the lens from the laser treatment.
Lai
Jimmy S M
JS
Department of Opthalmalogy, United Christian Hospital, Kowloon, Hong Kong. laism@ha.org.hk
Tham
Clement C Y
CC
Chua
John K H
JK
Poon
Agnes S Y
AS
Lam
Dennis S C
DS
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D015812:Glaucoma, Angle-Closure / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D032801:Iridectomy / Q000379:methods*; D007498:Iris / Q000601:surgery*; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016896:Treatment Outcome; D014792:Visual Acuity