Argon laser peripheral iridoplasty versus conventional systemic medical therapy in treatment of acute primary angle-closure glaucoma: A prospective, randomized, controlled trial1 ☆,
Section snippets
Materials and methods
Prior approval of the study protocol by the Ethics Committees of the Chinese University of Hong Kong and United Christian Hospital was obtained. We recruited patients at their first presentation of acute PACG at the Prince of Wales Hospital and the United Christian Hospital. The study period was from July 2000 to August 2001. Other inclusion criteria were: (1) age more than 18 years and ability to give informed consent and to cooperate for a slit-lamp laser procedure; (2) IOP levels of 40 mmHg
Results
During the study period from August 2000 to August 2001, a total of 73 eyes with acute PACG (64 patients) were recruited into the study. Thirty-three eyes of 32 patients were randomized to receive immediate ALPI, whereas 40 eyes of 32 patients received the conventional systemic medical regimen. Table 1 summarizes the demographic data of these 73 eyes. Using the independent samples t test, there were no statistically significant differences in age (P = 0.899), duration of attack (P = 0.716),
Discussion
Immediate ALPI has many advantages over conventional systemic IOP-lowering medications in the management of acute PACG. We have demonstrated in this study that ALPI reduces IOP significantly more rapidly than systemic medications in the first 2 hours after the initiation of treatment. This is not unexpected because medications take time for their onset of action, whereas ALPI acts directly on the peripheral iris with immediate effect. The more rapid IOP reduction may mean less permanent damage
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Supported by a Research Grants Council Earmarked Grant, Hong Kong.
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The authors have no proprietary interest in the products of devices mentioned herein.