title: Clinical outcomes of peripheral iridotomy in patients with the spectrum of chronic primary angle closure.
abstract: Purpose. To evaluate outcomes of peripheral iridotomy (PI) for initial management of primary angle closure suspects (PACS), chronic primary angle closure (CPAC), and chronic primary angle closure glaucoma (CPACG). Patients and Methods. Seventy-nine eyes with PACS, CPAC, or CPACG and better than 20/50 visual acuity that underwent PI as initial management were included. Eyes with previous acute angle closure attacks, laser trabeculoplasties, surgeries, or intraocular injections were excluded. Additional treatments, glaucomatous progression, intraocular pressure, visual acuity, and the number of medications were evaluated. Results. The mean followup was 57.1 ± 29.0 months (range 13.8-150.6 months). Sixty-eight eyes (86.1%) underwent additional medical, laser, or surgical treatment. Forty eyes (50.6%) underwent lens extraction due to reduced visual acuity. The mean 10× logMAR visual acuity score for all patients significantly declined from 0.94 ± 1.12 at baseline to 1.83 ± 3.49 (N = 79, P = 0.0261) at the last followup. Conclusions. Most patients who undergo PI for CPAC spectrum will require additional intervention for either IOP lowering or improvement of visual acuity. This suggests that a procedure that not only deepens the angle but also lowers IOP and improves visual acuity would be desirable as further intervention could be avoided. Evaluation of techniques that achieve all 3 goals is warranted.
authors.affiliation: Ruiz Department of Ophthalmology and Visual Science, The University of Texas Medical School at Houston, 6431 Fannin Street, MSB 7.024, Houston, TX 77030, USA ; Ophthalmology Department, Medical School, University of Puerto Rico, Medical Science Campus, P.O. Box 365067, San Juan, PR 00936, USA.
authors.forename: Ricardo J
authors.initials: RJ
authors.lastname: Cumba
authors.affiliation: Ruiz Department of Ophthalmology and Visual Science, The University of Texas Medical School at Houston, 6431 Fannin Street, MSB 7.024, Houston, TX 77030, USA ; Department of Ophthalmology, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, Mail Code 6230, San Antonio, TX 78229, USA.
authors.forename: Kundandeep S
authors.initials: KS
authors.lastname: Nagi
authors.affiliation: Ruiz Department of Ophthalmology and Visual Science, The University of Texas Medical School at Houston, 6431 Fannin Street, MSB 7.024, Houston, TX 77030, USA ; Robert Cizik Eye Clinic, 6400 Fannin Street, Suite 1800, Houston, TX 77030, USA.
authors.forename: Nicholas P
authors.initials: NP
authors.lastname: Bell
authors.affiliation: Ruiz Department of Ophthalmology and Visual Science, The University of Texas Medical School at Houston, 6431 Fannin Street, MSB 7.024, Houston, TX 77030, USA ; Robert Cizik Eye Clinic, 6400 Fannin Street, Suite 1800, Houston, TX 77030, USA.
authors.forename: Lauren S
authors.initials: LS
authors.lastname: Blieden
authors.affiliation: Ruiz Department of Ophthalmology and Visual Science, The University of Texas Medical School at Houston, 6431 Fannin Street, MSB 7.024, Houston, TX 77030, USA.
authors.forename: Alice Z
authors.initials: AZ
authors.lastname: Chuang
authors.affiliation: Ruiz Department of Ophthalmology and Visual Science, The University of Texas Medical School at Houston, 6431 Fannin Street, MSB 7.024, Houston, TX 77030, USA.
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Mankiewicz
authors.affiliation: Ruiz Department of Ophthalmology and Visual Science, The University of Texas Medical School at Houston, 6431 Fannin Street, MSB 7.024, Houston, TX 77030, USA ; Robert Cizik Eye Clinic, 6400 Fannin Street, Suite 1800, Houston, TX 77030, USA.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Feldman