Laser peripheral iridoplasty for angle-closure.
BACKGROUND
Angle-closure glaucoma is a leading cause of irreversible blindness in the world. Treatment is aimed at opening the anterior chamber angle and lowering the IOP with medical and/or surgical treatment (e.g. trabeculectomy, lens extraction). Laser iridotomy works by eliminating pupillary block and widens the anterior chamber angle in the majority of patients. When laser iridotomy fails to open the anterior chamber angle, laser iridoplasty may be recommended as one of the options in current standard treatment for angle-closure. Laser peripheral iridoplasty works by shrinking and pulling the peripheral iris tissue away from the trabecular meshwork. Laser peripheral iridoplasty can be used for crisis of acute angle-closure and also in non-acute situations.


OBJECTIVE
To assess the effectiveness of laser peripheral iridoplasty in the treatment of narrow angles (i.e. primary angle-closure suspect), primary angle-closure (PAC) or primary angle-closure glaucoma (PACG) in non-acute situations when compared with any other intervention. In this review, angle-closure will refer to patients with narrow angles, PAC and PACG.


METHODS
We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library), MEDLINE, EMBASE and LILACS (Latin American and Caribbean Literature on Health Sciences). The databases were last searched on 11 February 2008.


METHODS
Only randomised controlled trials (RCTs) were eligible for inclusion in this review. Patients with narrow angles, PAC or PACG were eligible. Studies that included only patients with acute presentations, using laser peripheral iridoplasty to break acute crisis were excluded.


METHODS
No analysis was carried out due to lack of trials.


RESULTS
There were no RCTs assessing laser peripheral iridoplasty in the non-acute setting of angle-closure.


CONCLUSIONS
There is currently no strong evidence for laser peripheral iridoplasty's use in treating angle-closure.
Ng
Wai Siene
WS
Cochrane Eyes and Vision, ICEH, London School of Hygiene & Tropical Medicine, Keppel Street, London, UK, WC1E 7HT. waisiene@doctors.org.uk
Ang
Ghee Soon
GS
Azuara-Blanco
Augusto
A
D015812:Glaucoma, Angle-Closure / Q000601:surgery*; D006801:Humans; D007498:Iris / Q000601:surgery*; D053685:Laser Therapy