Ophthalmology in China ›› 2015, Vol. 24 ›› Issue (4): 234-239.doi: 10. 13281/j. cnki. issn.1004-4469. 2015. 04. 005

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The constitution of chronic PACG in PACG with acute attack and its treatment effects

LI Si-zhen, LIANG Yuan-bo, WANG Ning-li, SUN Xia, FAN Su-jie, SUN Lan-ping, LIU Wen-ru, SUCIJANTI   

  1. 1. Nanjing Aier Eye Hospital, Nanjing 210006, China; 2. The Affiliated Eye Hospital of Wenzhou Medical University, Wenzhou 325027, China; 3. Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; 4. Handan Eye Hospital, Handan 056005, China.
  • Received:2014-10-29 Online:2015-07-25 Published:2015-08-18
  • Contact: WANG Ning-li, Email: wningli@vip.163.com

Abstract: Objective To determine the constituent ratio of chronic PACG (CPACG) and acute PACG (APACG) in PACG with acute attack, and compare the difference of the results of treatment. Design Case-controlled study. Participarts Consecutive PACG patients (159 patients, 159 eyes) with acute attack. Methods Subjects were recruited and received one of two treatment options: immediate laser peripheral iridoplasty (LPIP) or intraocular pressure (IOP)-lowering medications. After the IOP was controlled, all the patients received examination: IOP, fundus examination, vertical cup-to-disc ratio (VCDR), visual field test, A-scan, UBM, gonioscopy, endocellium cell cunt (ECC), etc. All patients were divided into two groups CPACG (VCDR≥0.6) and APACG (VCDR<0.6), and received laser peripheral iridotomy (LPI). There was no further treatment if IOP ≤21 mmHg and IOP-lowering medicine would be added if IOP>21 mmHg. Filtering surgery would be performed when medicine did not decrease IOP effectively. Main Outcome Measures VCDR, IOP, acute attack duration (AD) , peripheral anterior synechia (PAS) extent, visual acuity, ECC, anterior chamber depth (ACD), lens thickness (LT), ocular axis length (AL), means defect (MD) of visual field and IOP-control-ratio. Results APACG (VCDR<0.6) occupied 85% in PACG with acute attack and CPACG (VCDR≥0.6) 15%, however APACG occupied 88.8% and CPACG 11.2% in PACG with AD≤168 h. PACG with AD≤168 h were further analyzed. There was no significant difference in AD between CPACG 23 h (12, 72) and APACG 15 h (10, 52) (P=0.508). PAS extents in CPCG 8.0 (3.0, 11.5) clocks were wider than APACG 2.0(0.0, 6.0) clocks (P=0.004). There was no significant difference in ACD and LT, but AL in CPACG (22.31±0.72 mm) were longer than in APACG (21.73±0.98 mm )(P=0.004). There was no significant difference in IOP between CPACG and APACG at the treatment of the acute stage. 73.6 % (92/125) patients accomplished 1 year’s follow-up after receiving LPI. The IOP control ratio of CPACG [55.6 % (5/9)] was lower than APACG [79.5 % (66/83)] (P=0.104). Conclusions CPACG occupies about a tenth in PACG with acute attack. CPACG had longer axial length and wider PAS extent than APACG. CPACG had a worse IOP control with LPI than APACG. ?(Ophthalmol CHN, 2015, 24: 234-239)

Key words: primary angle closure glaucoma(PACG), acute attack, laser peripheral iridectomy