Limited argon laser peripheral iridoplasty as immediate treatment for an acute attack of primary angle closure glaucoma: a preliminary study.

PURPOSE: To study the efficacy and safety of limited (180 degrees) argon laser peripheral iridoplasty (ALPI) as a first-line treatment for acute primary angle closure glaucoma (PACG) without the use of systemic anti-glaucomatous medications.

METHODS: Ten consecutive patients with PACG were recruited into the study. Each patient received topical pilocarpine (4%) and timolol (0.5%), and immediate limited ALPI as primary treatment. The intraocular pressures at 15, 30 and 60 min after ALPI were documented by Goldmann applanation tonometry.

RESULTS: The mean intraocular pressure (IOP) of this group of patients was reduced from 57.9 +/- 10.6 mmHg to 39.0 +/- 10.9 mmHg at 15 min, 28.3 +/- 9.1 mmHg at 30 min and 20.4 +/- 9.0 mmHg at 60 min after ALPI. No complications were encountered. In 8 of the 10 patients the corneal oedema cleared 1 h after ALPI. In the remaining 2 patients the corneal oedema cleared 2 h after ALPI.

CONCLUSION: Immediate limited ALPI, without adjunctive systemic anti-glaucomatous medications, appeared to be effective and safe in controlling the IOP in treating acute PACG with a duration of attack < or = 48 h. It may be as effective as 360 degrees ALPI, and therefore has a role in those patients in whom 360 degrees treatment is not possible.