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Journal of Ophthalmology
Volume 2017, Article ID 2761301, 6 pages
https://doi.org/10.1155/2017/2761301
Research Article

Laser Peripheral Iridotomy versus Trabeculectomy as an Initial Treatment for Primary Angle-Closure Glaucoma

1Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China
2Handan Eye Hospital, Handan, Hebei Province, China
3The Affiliated Eye Hospital, School of Optometry and Ophthalmology, Wenzhou Medical University, China
4School of Medicine, Dentistry and Biomedical Sciences Public Health, Health Services and Primary Care, Queen’s University, Belfast, UK
5Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
6Anyang Eye Hospital, Anyang, Henan Province, China
7Fushun Eye Hospital, Fushun, Liaoning Province, China
8Queensland Eye Institute, Brisbane, Queensland, Australia
9University of Queensland, Brisbane, Queensland, Australia
10Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China

Correspondence should be addressed to Yuan Bo Liang; moc.621@gnailobnauy

Received 19 November 2016; Revised 28 May 2017; Accepted 13 June 2017; Published 1 September 2017

Academic Editor: Jesús Pintor

Copyright © 2017 Yan Yun Chen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. To compare laser peripheral iridotomy (LPI) with trabeculectomy as an initial treatment for primary angle-closure glaucoma (PACG) with peripheral anterior synechiae (PAS) ≥ 6 clock hours. Methods. Patients were drawn from two randomized controlled trials. 38 eyes of 38 patients (PAS ≥ 6 clock hours) were treated with LPI (group 1) while 111 eyes of 111 PACG patients (PAS ≥ 6 clock hours) underwent primary trabeculectomy (group 2). All patients underwent a comprehensive ophthalmic examination at baseline and at postoperative visits and were followed up for a minimum of one year. Results. Group 2 had higher baseline IOP (45.7 ± 14.8 mmHg versus 34.3 ± 14.3 mmHg) than group 1 and more clock hours of PAS (10.4 ± 1.9 versus 9.0 ± 2.2). IOPs at all postoperative visits were significantly lower in group 2 than in group 1 (). Five eyes in group 1 required trabeculectomy. 17 of the 38 eyes in group 1 (44.7%) required IOP-lowering medications as compared to seven of the 111 eyes in group 2 (6.3%). Cataract progression was documented in 2 eyes (5.3%) in group 1 and 16 eyes (14.4%) in group 2. Conclusions. Primary trabeculectomy for PACG (PAS ≥ 6 clock hours) is more effective than LPI in lowering IOP.