| Purpose: to investigate the efficacy of laser iridoplasty performed in different phase of acute primary angle closure glaucoma.
Design: non-randomized, controlled clinical trial.
Participants and methods: 138 patients with 162 eyes of acute primary angle closure glaucoma were assigned to experimental group and control group according to their presenting time, those presented during daytime (from 8am to 5pm) were assigned to control group while those presented during nighttime (form 5pm to 8am) were assigned to the study group. In study group, conventional medications were adimistated to decrease the elevated IOP, then iridotomy, followed by iridoplasty one or two days later if peripheral anterior synaechia (PAS) was found. Controls were undergone iridoplasty firstly to decrease the elevated IOP, followed by iridotomy one or two days later. Visual acuity, intraocular pressure (IOP), slit lamp, visual field, gonioscopy, fundus examination were performed during the 1 day, 3 day, 7day, 2 week, 1 month, 3 months, 6 months, 12 months postoperatively.
Main outcome measures: intraocular pressure (IOP), the extent of PAS, complications.
Results: with mean follow-up time of 6 months, the success rate was no significant difference between experimental and control group (p=0.736~0.926), the filter surgery rate in experimental group was 10.1% and 19.4% in control group, however no statistical significance (p=0.109). The mean survival time in experimental and control group was 341 days with a median of 406 days and 321days with a median of 365 days, respectively ( p=0.189). The extent of PAS in experimental and control group was 4.14±3.72 hours，4.79±4.05 hours (p=0.319). In this study, the the extent of PAS could be reduced by one clock hour more in sutdy group. The corneal endothelia cells count in control group was reduced by 250cells/mm2 in attacked eyes comparing to the contralateral eyes (p=0.01), while no significant reduction in experimental group (p=0.38). The success rates of controlling the acute elevated IOP in study and control group at postoperative 1hour, 2 hour, 6hour are, 21.6% Vs 26.1% (p=0.681), 45.9% Vs 46.6% (p=0.949), 81.1% Vs 70.5% (p=0.219), respectively.
Conclusions: The outcomes of laser iridoplasty conducted in acute stage and after IOP decreased are nearly equal. But iridoplasty conducted during acute stage may have a greater damage to corneal endothelial cells.
Keywords: acute angle-closure glaucoma, laser iridotomy, laser iridoplasty, clinical trial
|
网友评论：（只显示最新10条。评论内容只代表网友观点，与本站立场无关！）