Abstract:

 Objective  To evaluate the effects of peripheral anterior synechia (PAS) on acute attack stage of acute primary angle-closure glaucoma (APACG) cases who received argon laser peripheral iridoplasty (LPIP). Design prospective comparative case series. Participants 116 patients (116 eyes) with acute stage of primary angle-closure glaucoma in Handan Eye Hospital. Methods 84 eyes received LPIP treatment (LPIP group) and 32 eyes received medical treatment (medical group). Intraocular pressure ( IOP) at 1, 2 and 6 hours (IOP1 h, IOP2 h, and IOP6 h) were measured after treatment. IOP, fundus examination, gonioscopy, endocellium cell count (ECC) was measured after the IOPs were controlled. Main outcome Measures IOP and PAS extent. Results Strong correlation was found between PAS and attack duration (AD) in LPIP group and medical group (r=0.579, 0.288; P<0.05).  Strong correlation was found between PAS and IOP2 h, IOP6 h in LPIP group (r=0.296, 0.334; P<0.05). PAS extent in AD≤24 h group (2.3±2.9 clocks) was smaller than AD>24 h group (6.2±4.0 clocks) ( P<0.001). There was no difference in IOP1 h, IOP2 h and IOP6 h between PAS≤6 clocks group and PAS>6 clocks group in APACG received medical treatment. IOP1 h (28.4±15.1), IOP2 h (22.0±13.1) and IOP6 h (17.9±8.52) in PAS≤6 clocks group were lower than those (35.5±15.5, 29.6±11.4, 24.9±10.4, P=0.066, 0.020, 0.003) in PAS>6 clocks group.  Conclusions  APACG with PAS≤6 clocks has better IOP control than those with PAS >6 clocks in LPIP. (Ophthalmol CHN, 2019, 28: 23-28)