title: Laser peripheral iridotomy with and without iridoplasty for primary angle-closure glaucoma: 1-year results of a randomized pilot study.
abstract: 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.
authors.affiliation: Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, People's Republic of China.
authors.forename: Xia
authors.initials: X
authors.lastname: Sun
authors.forename: Yuan Bo
authors.initials: YB
authors.lastname: Liang
authors.forename: Ning Li
authors.initials: NL
authors.lastname: Wang
authors.forename: Su Jie
authors.initials: SJ
authors.lastname: Fan
authors.forename: Lan Ping
authors.initials: LP
authors.lastname: Sun
authors.forename: Si Zhen
authors.initials: SZ
authors.lastname: Li
authors.forename: Wen Ru
authors.initials: WR
authors.lastname: Liu
mesh_terms: 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