Non-conventional (180 degrees) Argon Laser Peripheral Iridoplasty as Immediate Treatment for an Acute Attack of Primary Angle Closure Glaucoma

Abstract

The purpose of this study is to evaluate the efficacy and safety of 180 degrees of argon laser peripheral iridoplasty (ALPI) as a first-line treatment for acute primary angle closure glaucoma (PACG) without the use of systemic antiglaucoma medications. A cohort of 10 patients with an acute attack of PACG were recruited into the study. Each patient received topical pilocarpine 2% and timolol 0.5% and immediate 180 degrees of ALPI as a primary treatment. The mean intraocular pressure (IOP) of this group of patients was reduced from 57.2 mm Hg to 38.1 mm Hg at 15 minutes, 28.3 at 30 minutes and 20.8 mm Hg at 1 hour. Immediate limited (180 degrees) ALPI without systemic antiglaucoma medication proved to be safe and effective in controlling the IOP in the acute attack of PACG with a duration of attack <= 48 hours. It may be as effective as 360 degrees ALPI and therefore has a role in those patients in home 360 degree treatment is not possible.