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Interventions for angle-closure glaucoma: an evidence-based update.

Seang-Mei Saw1, Gus Gazzard, David S Friedman

  • 1Department of Community, Occupational and Family Medicine, National University of Singapore, 16 Medical Drive, Singapore 117597, Republic of Singapore. cofsawsm@nus.edu.sg

Ophthalmology
|October 3, 2003
PubMed
Summary
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Laser peripheral iridotomy (LPI) is effective for acute angle closure (AAC) and primary angle closure (PAC). For PAC cases unresponsive to LPI, latanoprost may lower intraocular pressure (IOP) more effectively than timolol.

Area of Science:

  • Ophthalmology
  • Glaucoma Research
  • Medical Interventions

Background:

  • Primary angle closure (PAC) is a leading cause of blindness in East Asia.
  • Optimal treatment guidelines for acute angle closure (AAC) and PAC are limited.
  • Glaucomatous optic neuropathy can complicate AAC and PAC.

Purpose of the Study:

  • To assess interventions for treating AAC and PAC.
  • To evaluate treatments for affected and contralateral eyes.
  • To determine efficacy in eyes with or without glaucomatous optic neuropathy.

Main Methods:

  • Systematic review of randomized clinical trials and controlled clinical trials.
  • Inclusion of retrospective case series with over 50 cases.
  • Searches of MEDLINE, PubMed, EMBASE, Cochrane Library, and reference lists.

Related Experiment Videos

Main Results:

  • Laser peripheral iridotomy (LPI) demonstrated comparable effectiveness to surgical peripheral iridectomy for AAC and PAC.
  • Latanoprost was found to be more effective than timolol in reducing intraocular pressure (IOP) for PAC patients unresponsive to LPI.
  • Nine randomized clinical trials and 24 nonrandomized trials/case series were evaluated.

Conclusions:

  • LPI is recommended for treating AAC and PAC in affected and contralateral eyes.
  • Latanoprost is a potential alternative for managing PAC when LPI is insufficient.
  • Further research is needed for other AAC and PAC interventions.