Clinical Observation of Laser Peripheral Iridoplasty with Number of Laser Shots in the Treatment of Acute Angle-Closure Glaucoma.

Objective: To quantitatively study the intraocular pressure (IOP) control and chamber angle opening degree of patients with acute angle-closure glaucoma (stage of attack) treated by laser peripheral iridoplasty (LPIP) with different numbers of laser shots, and to evaluate the efficacy and safety of different numbers of laser shots.

Methods: Fifty-five patients (60 eyes) with acute angle-closure glaucoma treated in our hospital from May 2019 to December 2020 were selected as the research subjects. All patients had poor intraocular pressure control (≥40 mmHg) after IOP-lowering drug therapy. The patients were randomly divided into three groups, 20 eyes in each group, and underwent laser peripheral iridoplasty (LPIP) with different numbers of laser shots (group I: 35 laser shots, group II: 45 laser shots, and group III: 60 laser shots). The best-corrected visual acuity, IOP, corneal condition, and opening degree of anterior chamber angle (ACA), namely, the trabecular-iris angle (TIA), angle opening distance at 500 m (AOD), and complications of patients before LPIP, 2 hours after LPIP, and 24 hours after LPIP were observed, and the opening degree of ACA were quantitatively measured.

Results: The corrected visual acuity of the three groups after LPIP was improved to varying degrees, and the IOP decreased, TIA and AOD were increased compared with those before operation, and the differences were statistically significant ( < 0.05). There were statistically significant differences between group II and group I ( < 0.05). Four eyes in group I underwent LPIP again due to increased IOP. In group III, iris hemorrhage occurred in one eye and iris depigmentation occurred in one eye, and there was no statistical difference compared with group II ( > 0.05).

Conclusions: LPIP can effectively reduce preoperative IOP and increase ACA width in patients with persistent high IOP that failed to respond to drug therapy, and moderate numbers of laser shots can achieve satisfactory results and highest safety.