Purpose  To evaluate the efficacy of argon laser peripheral iridoplasty (ALPI) on severe Chinese patients with acute angle closure glaucoma (AACG) who have responded poorly to intensive medical therapy. 
Methods  Fifteen eyes of fifteen medically unresponsive Chinese patients (3 males and 12 females), who presented with acute attack of AACG and had an IOP of ≥ 40mmHg under intensive anti-glaucoma medication for more than two days, received ALPI in Beijing Tongren Eye Center were studied. Main outcome measurements include visual acuity and intraocular pressure (IOP). 
Results  The mean age of the patients were 59.6 ± 11.2 (ranging from 44 to 75) years old. All patients were affected unilaterally. The mean period of medical treatment before ALPI was 3.33 ± 2.28 (ranging from 2 to 11) days. The average IOP of the affected eyes dropped from 54.7 ±11.1 (ranging from 41 to 82) mmHg just before laser treatment to 18.6±13.1 (ranging from 10 to 62) mmHg two hours after ALPI, with a mean fall of 36.7± 10.5 (ranging from 14 to 50) mmHg. 73% (11/15) of the patients gained satisfactory IOP control of ≤21 mmHg at post-laser therapy two hours later. Visual acuity improved in all patients except that in a patient who had no light perception before ALPI. 
Conclusions  ALPI is an effective technique in cutting short acute attack of Chinese AACG patients who have responded poorly to intensive medication.