Observation on the efficacy of Nd:YAG laser peripheral iridotomy in the treatment of drug-uncontrollable PACG in acute attack

Abstract

AIM: To explore the effects of Nd:YAG laser peripheral iridotomy(LPI)in the treatment of drug-uncontrollable primary angle-closure glaucoma(PACG)in acute attack.METHODS: A prospective study was conducted on 22 eyes of 20 patients with drug-refractory primary angle-closure glaucoma treated in the Department of Ophthalmology of Xiangyang No.1 People's Hospital from May 2019 to June 2020. All subjects underwent Nd:YAG LPI. Visual acuity, intraocular pressure, chamber angle closure range, anterior chamber angle(ACA), anterior chamber volume(ACV), central anterior chamber depth(CACD)and peripheral anterior chamber depth(PACD)were measured before and after the operation. And observe the complications of LPI.RESULTS:All patients can implement LPI. All subjects' chamber angle closure range were >180° before LPI and 9 eyes(41%)were ≤180° after LPI. The intraocular pressure of 21 eyes(95%)had significantly lower than postoperative(P<0.05). Postoperative anterior chamber parameters such as ACA, ACV and PACD were increased(P<0.05). During the operation,15 eyes(68%)had iris cascade or silk hemorrhage and 5 eyes(23%)had corneal epithelial damage.CONCLUSION: LPI has high safety and can be implemented in the acute attack stage of drug-uncontrollable PACG. It can reduce intraocular pressure effectively and relieve symptoms, which has a significant effect in the patients.

Keywords

• primary angle-closure glaucoma
• acute attack stage
• laser peripheral iridotomy