Purpose:To investigate the long-term fluctuation of intraocular pressure (IOP) of Primary angle closure diseases and its associations following laser peripheral iridotomy(LPI) /laser peripheral iridoplasty.
Patients and Methods:158 patients in a randomized clinical trial, which aimed to compare the efficacy and safety of LPI/laser peripheral iridoplasty in eyes with primary angle closure suspect (PACS), synechial primary angle-closure (PAC) / primary angle closure glaucoma (PACG), had been followed up for 12 months or more. IOP was measured with Goldman applanation tonometer at each scheduled visits time. IOP fluctuation was defined as the Max IOP minus the Min IOP from post-operative day14 to month12 or more. Multiviarite linear regression with generalized estimating equation (GEE) regression models was used to evaluate the association of IOP fluctuation with gender, age, baseline IOP, baseline peripheral anterior synechia (PAS), baseline C/D ratio, baseline MD, need for medications.
Results:158 patients were included in the RCT. 32 patients underwent trabeculectomy during follow-up and 33 patients dropped out of follow up and have been excluded. 157 eyes of the rest 93 patients (21 eyes of PACS, 81 eyes of PAC, 55 eyes of PACG) were included in this study. PAS in PAC group and PACG group was reduced 2-3 clock hours posterior to LPI. Mean IOP during follow-up in PACS, PAC, PACG group were 15.24±2.13, 16.18±2.28, 18.82±4.28 mmHg, respectively. IOP fluctuation during follow-up in these 3 group were 4.83±2.90, 5.67±3.35, 9.40±7.14 mmHg, respectively. IOP fluctuation was strongly correlated with baseline IOP(r=0.356, p<0.001), the extent of PAS (r=0.374, p<0.001). GEE regression models found IOP fluctuation was higher in patients with higher baseline IOP (0.176 mmHg per unit increase, 95 % CI: 0.048-0.305 mmHg).
Conclusions:Long-term IOP fluctuation in PACG group is larger than that in PACS/PAC group. Eyes with higher baseline IOP were observed to have larger long-term IOP fluctuation. |
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