title: Effect of anterior chamber paracentesis on initial treatment of acute angle closure.
abstract: OBJECTIVE
  To compare anterior chamber paracentesis (ACP) with standard medical management of acute primary angle closure (APAC).
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Patients with APAC and intraocular pressure (IOP) ≥ 50 mm Hg were enrolled.
  
  
  METHODS
  Patients were randomized to receive ACP and medical treatment (group 1) or medical management alone (group 2).
  
  
  RESULTS
  There were 26 patients (mean age 69.3 ± 10.4 years, 31 eyes) in group 1 and 28 patients (mean age 67.0 ± 9.7 years, 30 eyes) in group 2. The IOP in group 1 was significantly lower at 15 minutes, 30 minutes, and 1 hour after treatment (p < 0.05). At 1, 2, and 24 hours after treatment, visual acuity was significantly better in group 1 than in group 2. At each time point after treatment, the grade of corneal edema was not different between the groups. Pain score at 1 and 2 hours after treatment was significantly lower in group 1 than in group 2; however, no difference was noted at 24 hours after treatment. The mean follow-up period in group 1 was 16.1 ± 1.3 months and in group 2 was 15.6 ± 1.4 months (p = 0.803). At last follow-up, IOP, pupil size, number of eyes with nonreactive pupils, and centre endothelial cell counts were not different; however, visual acuity was significantly better in group 1 (0.43 ± 0.06 logMAR vs 0.74 ± 0.10 logMAR, p = 0.007).
  
  
  CONCLUSIONS
  Immediate ACP is a safe and effective for rapidly lowering IOP, and is associated with better visual acuity than medical treatment alone.
authors: State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou.
authors: Xuejiao
authors: X
authors: Yang
authors: Wenru
authors: W
authors: Su
authors: Mei
authors: M
authors: Wang
authors: Yujing
authors: Y
authors: Bai
authors: Yiqing
authors: Y
authors: Li
authors: Jian
authors: J
authors: Ge
authors: Yehong
authors: Y
authors: Zhuo
mesh_terms: D000208:Acute Disease; D000368:Aged; D000867:Anterior Chamber / Q000502:physiology; D058447:Eye Pain / Q000503:physiopathology; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D019152:Paracentesis / Q000379:methods*; D011446:Prospective Studies; D014065:Tonometry, Ocular; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests; D014794:Visual Fields