| Objectives: to compare the results of two-staged combination of laser iridotomy and iridoplasty with laser iridotomy in chronic angle closure glaucoma.
Design: parallel randomized, controlled, clinical trial
Participants and methods: 160 patients with choronic angle closure glaucoma, which was defined as peripheral anterior synaechia could be found more than 0.5 clock houre with dynamic gonioscopy, were divided into two groups. In experimental group, iridotomy was undergone followed with laser iridoplasty one or two days later, in control group, only laser iridotomy was performed. Visual acuity(VA), intraocular pressure(IOP), slit lamp, gonioscopy, visual field test, fundus examination were done at the post-therapeutive 1 days,3 days,7days,2 weeks,1 months,3 months,6 months,12 months,18 months.
The main outcome measures: IOP, the extent of peripheral anterior synechia (PAS) and complications.
Results: 81 patients with 81 eyes of chronic angle closure glaucoma were enrolled into experimental group, 79 patients with 79 eyes were enrolled into control group. With a mean follow up time of 6 months, the success rate was 51.9% (42/81) in experimental group and 53.2% (42/79) in control group with no statistical significance (p=0.868). The IOP of last visit was 20.50±9.18 in experimental group and 20.15±7.42 mmHg, with no significant difference (p=0.796). The mean survival time in experimental group and control group was 290±23 days and 281±22 days, respectively (p=0.970). The extent of PAS reduced one more clock hour in experimental group than that in control group (p=0.02). However, the extent of PAS increased 0.5 clock hour in experimental group (p=0.012), while no significant change was found in control group (p=0.751). The number of endothelial cell counts and complications between two groups was no difference.
Conclusions: The efficacy of iridotomy followed by iridoplasty for choronic angle closure glaucoma was no difference with iridotomy only for angle closure glaucoma. Although iridotomy can lyses the synechiae, it may also be a factor to accelerate the progression of PAS thereafter.
Keywords: chronic angle-closure glaucoma, laser iridoplasty, laser iridotomy, randomized clinical trial, peripheral anterior synechiae.
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