| Objectives: to provide a profile of the actual status of the clinical practice of primary angle closure glaucoma (PACG) in Mainland of China.
Design: non-randomized sample, questionnaire.
Participants and methods: In glaucoma section of 10th Congress of Chinese Ophthalmological Society in Tianjing, 330 ophthalmologists were requested to fill the form of questionnaire independently. 293 files were reclaimed. 31 files were excluded because more than 10% of requested questions missed or not met the requirement of logic check. The valid response rate was 79.4％(262/330).
Results: the participants were from 29 provinces except for Hainan province. 98.8% of ophthalmologists（253/257）agreed that community-based screening of PACG should be conducted. 81.5%（212/260）regarded gonio evaluation as routine examination for PACG suspects. The rate of trabeculectomy of acute angle closure (AAC) was 66.7%（Median: 75%，range: 10%~100%）. 53.1%（139/262）believed that Argon laser iridoplasty is a good alternation therapy for AAC and 31.3% of them had applied this procedure in their practice. The ratio of laser peripheral iridotomy for peripheral iridectomy was about 39.6%(Median 35%，range: 0~100%). 39.3% of them (103/262) applied medication treatment as the first choice for early stage of PAC, while only 58.8% of them (154/262) preferred iridectomy/iridotomy firstly. 60 percent of ophthalmologists regard the extent of PAS as the most important factor for the decision-making to do trabeculectomy or iridotomy, especially, 57.8%(85/157) ophthalmologists choose trabeculectomy for those with PAS >6 clock hours.73.3% of participants choose trabeculectomy as the first choice for chronic angle closure glaucoma (CACG). Releasable suture were performed in all patients of PACG by 27.1% of the participants, while 18.3% of them never did it. The rate of follow-up exceeded one year varied from 10% to 90% in different hospital, the major factor of hinder them from good compliance was poor glaucoma awareness.
Conclusions: The conception of angle-closure glaucoma diagnosis and management varies greatly in different areas, different hospitals. The main therapetutic methods for angle closure glaucoma are non-laser preferred, such as drugs and surgery. The indications for surgery are mainly depended on the extent of peripheral anterior synechiae (PAS). Most ophthalmologists perform trabeculectomy on those with PAS exceeding 6 clock hours, while iridotomy will be chosen for those with PAS less than 6 clock hours.
Key Words: primary angle-closure glaucoma, questionnaire, ocular surgery.
|
