Laser peripheral iridotomy with and without iridoplasty for primary angle-closure glaucoma: 1-year results of a randomized pilot study.
OBJECTIVE
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.


METHODS
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.
Sun
Xia
X
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, People's Republic of China.
Liang
Yuan Bo
YB
Wang
Ning Li
NL
Fan
Su Jie
SJ
Sun
Lan Ping
LP
Li
Si Zhen
SZ
Liu
Wen Ru
WR
D000368:Aged; D002452:Cell Count; D004728:Endothelium, Corneal / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D015812:Glaucoma, Angle-Closure / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D032801:Iridectomy; D007498:Iris / Q000601:surgery*; D017075:Laser Coagulation; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011183:Postoperative Complications; D014065:Tonometry, Ocular; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology