Examination and treatment of patients with angle-closure glaucoma in Japan: results of a nationwide survey.
OBJECTIVE
To assess the present state of examination procedures and treatments for angle-closure glaucoma (ACG) in Japan.


METHODS
A nationwide questionnaire survey was conducted, targeting 1237 registered facilities to Japanese Ophthalmological Society.


RESULTS
Valid replies were obtained from 754 of 1232 facilities (61.2%). Primary ACG comprised a small percentage of the glaucoma types diagnosed in outpatient examinations. More than 50% of the laser iridotomy (LI) procedures were prophylactic at 52.9% of the facilities. Gonioscopy was most frequently used for determining indications for prophylactic LI. Specular microscopy was always performed prior to LI in 7.8% of the facilities. Prophylactic LI resulted in complications at 20.5% of the surveyed facilities, although the incidence was low. The following residual complications were reported at 82.9% of the facilities when treating ACG attacks: cataract, persistent elevation of intraocular pressure, and bullous keratopathy. One-third of the facilities experienced inadequate treatment of an ACG attack by physicians other than ophthalmologists.


CONCLUSIONS
The incidence of LI-induced complications was higher in ACG eyes than in narrow-angle eyes. However, prophylactic LI sometimes results in persistent ocular complications.
Kashiwagi
Kenji
K
Department of Ophthalmology, University of Yamanashi Faculty of Medicine, Tamaho, Japan. kenjik@yamanashi.ac.jp
Tsukahara
Shigeo
S
D015812:Glaucoma, Angle-Closure / Q000175:diagnosis* / Q000601:surgery*; D006306:Health Surveys; D006801:Humans; D032801:Iridectomy; D007564:Japan; D053685:Laser Therapy; D008853:Microscopy; D009885:Ophthalmology / Q000706:statistics & numerical data; D011183:Postoperative Complications; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012955:Societies, Medical / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires