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To Study the Efficacy of Laser Peripheral Iridoplasty in the Treatment of Eyes With Primary Angle Closure and Plateau Iris Syndrome, Unresponsive to Laser Peripheral Iridotomy, Using Anterior-Segment OCT as a Tool
摘要： The article discusses the efficacy of laser peripheral iridoplasty (LIP) in treating eyes with primary angle closure and plateau iris syndrome, unresponsive to laser peripheral iridotomy (LPI), using anterior-segment OCT as a tool. It highlights the importance of angle anatomy in the pathomechanism of primary angle closure glaucoma and the role of ASOCT in providing an objective picture of angle structures over time and after interventions. The study was conducted on 100 eyes of primary angle closure randomized to undergo either LPI or LPI plus LIP, with results showing significant IOP lowering in the LIP group, especially in eyes with appositional closure and synechiae <180 degrees.
关键词： intraocular pressure,plateau iris syndrome,primary angle closure,anterior-segment OCT,laser peripheral iridoplasty
更新于2025-09-16 10:30:52
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Argon Laser Peripheral Iridoplasty and Argon Laser Pupilloplasty: Alternative Management for Medically Unresponsive Acute Primary Angle Closure
摘要： Objective. To introduce the combined laser technique, argon laser peripheral iridoplasty (ALPI) and argon laser pupilloplasty (ALPP), in the management of medically unresponsive acute primary angle closure (APAC). Design. Retrospective study. Methods. We retrospectively reviewed the records of 23 patients (27 eyes) with APAC, who were applied ALPI and ALPP when traditional treatment failed. The visual acuity and intraocular pressure (IOP) were monitored before surgery and at 1, 2, 12, 24, and 48 h after surgery. Additionally, the angle-opening status was monitored before surgery and 48 h after the treatment by using an ultrasonic biological microscope (UBM), and the presurgical and postsurgical cornea edema statuses were observed by using a slit lamp. We also documented the complications of laser treatment. Results. For the ALPI + ALPP laser-effective group, the presurgical IOP was 37.6 ± 10.9 mmHg (1 h), 28.4 ± 12.4 mmHg (2 h), 19.9 ± 9.0 mmHg (6 h), 16.8 ± 7.3 mmHg (12 h), 15.9 ± 5.9 mmHg (24 h), and 14.9 ± 5.0 mmHg (48 h), with statistically significant differences (p < 0.05) in each time point. It was observed in all the patients that the corneal edema alleviated, the angles opened, and visual acuity recovered with varying degrees at 48 h after applying combined laser treatment. For the ALPI + ALPP laser-ineffective group, further interventions were taken. Definitive treatment was given in both groups to maintain the long-term IOP control. Conclusions. Although the combination of ALPI and ALPP is a temporizing therapeutic strategy for APAC, it is effective in relieving pupillary block which is unresponsive to miotic agents, opening the closed angle to a certain extent, restoring the transparency of cornea, and reducing IOP to a safe level for further definitive treatment.
关键词： acute primary angle closure,argon laser peripheral iridoplasty,argon laser pupilloplasty,corneal edema,intraocular pressure
更新于2025-09-11 14:15:04