[Importance of laser peripheral iridoplasty in the treatment of acute closed-angle glaucoma]

The aim of this prospective study has been to evaluate effectivity of laser peripheral iridoplasty (ALPI) as a first choice therapy for intraocular pressure (IOP) reduction in acute primary angle-closure glaucoma (PACG). The study included 12 patients with the first attack of acute glaucoma in whom IOP in spite of continuing medical therapy for 12 hours persisted at the level of 5.32 kPa (40.0 mmHg) and higher. We used Argon laser manufactured by HGM E-005. Laser parameters were: spot size 300-500 um, time 0.2-0.5 s, intensity 300-500 mW. Laser burns were placed to the whole circumference of the iridocorneal angle numbering 50-60 with the use of Goldmann contact lens. Applanation tonometry was used to measure IOP shortly before the laser therapy and 1 and 2 hours after ALPI. The mean IOP prior to treatment was 6.00 +/- 1.46 kPa (51.7 +/- 11.04 mmHg). The mean IOP 1 hour after ALPI was 2.77 +/- 0.44 kPa (20.83 +/- 3.31 mmHg) and after 2 hours 2.39 +/- 0.26 kPa (18.0 +/- 2.0 mmHg) which represents 45.8% reduction in IOP. Two hours after treatment all patients had transparent corneas. The results of this study confirm that ALPI effectively reduces IOP and enhances transparency of the cornea in acute PACG for the definitive treatment by laser iridotomy.