title: Argon laser peripheral iridoplasty versus systemic intraocular pressure-lowering medications as immediate management for acute phacomorphic angle closure.
abstract: BACKGROUND
  The purpose of this study was to compare the efficacy and safety of argon laser peripheral iridoplasty (ALPI) and systemic intraocular pressure (IOP)-lowering medications in the immediate management of acute phacomorphic angle closure.
  
  
  METHODS
  Consecutive cases of acute phacomorphic angle closure were randomized to receive ALPI and an intravenous or oral carbonic anhydrase inhibitor as initial treatment. Intravenous mannitol was administered for presenting IOP > 60 mmHg or IOP > 40 mmHg 2 hours posttreatment in both arms.
  
  
  RESULTS
  Of 10 consecutive cases, six received medical therapy and four received ALPI. Fifty percent in the medical group and none in the ALPI group required intravenous mannitol. The ALPI group took less time to achieve IOP < 25 mmHg (18.8 ± 7.5 minutes versus 115.0 ± 97.0 minutes, P = 0.001, F test); had a greater IOP reduction within 30 minutes (69.8% ± 7.7% versus 40.9 ± 23.9%, P = 0.03, t-test); and had a consistently smaller post-attack cup to disc ratio (0.50 ± 0.02 versus 0.60 ± 0.20, P = 0.002, F test).
  
  
  CONCLUSIONS
  ALPI offers greater safety, consistency, and efficacy than systemic IOP-lowering medications as initial treatment for phacomorphic angle closure.
authors: Department of Ophthalmology, University of Hong Kong, People's Republic of China.
authors: Jacky Wy
authors: JW
authors: Lee
authors: Jimmy Sm
authors: JS
authors: Lai
authors: Doris Wf
authors: DW
authors: Yick
authors: Can Yf
authors: CY
authors: Yuen
keywords: argon laser peripheral iridoplasty; glaucoma; intraocular pressure; medical; phacomorphic