Acute Primary Angle Closure Resolved After Medical Treatment in a Quarter of Eyes, Study Finds

ByRachelle R. Sowell

Jul 7, 2022 , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

A retrospective review found that 26% of eyes with acute most important angle closure (APAC) ended up settled right after preliminary healthcare treatment method.

A analyze published in the Journal of Ophthalmology identified that 26% of eyes with acute main angle closure (APAC) saw enhancement soon after original treatment, with 33% of eyes needing laser iridotomy (LI) and 40% of eyes needing lensectomy.

APAC is an ophthalmic issue that needs unexpected emergency therapy, very first with topical therapies and then with surgical intervention if needed, to take care of the improved intraocular pressure (IOP) that success from the acute attack.

This analyze made use of 87 eyes from 87 patients (17 gentlemen and 80 girls) with a mean (SD) age of 69. (9.) years. All clients produced APAC amongst January 2006 and June 2020 at Kitasato College Healthcare facility. All individuals required to comprehensive at the very least a 3-month abide by-up to be bundled.

Individuals who had a record of ocular operation, ocular trauma, or other concomitant eye sickness outside the house of glaucoma were being excluded from the review. Only 1 eye was randomly picked out from every client for examination if bilateral APAC experienced occurred.

All eyes been given topical 2% pilocarpine and systemic mannitol administration. Surgical procedure was executed immediately after that if APAC was not resolved at first cure, and all patients who wanted surgical procedures were separated into LI and lensectomy teams. Most effective spectacle-corrected visible acuity (BSCVA), selected procedure approach, IOP, and corneal endothelial mobile density (ECD) were all calculated at the last comply with-up.

The signify (SD) pretreated IOP in the review population was 56.4 (9.) mm Hg (95% CI, 38.7-74.1 mm Hg). People went a necessarily mean (SD) of 1.6 (2.7) days among onset of subjective indicators and clinical assessment. The imply (SD) follow-up time period was 15.5 (19.3) months.

Of the 87 eyes with APAC, 23 eyes (26%) ended up resolved right after initial cure. There have been 29 (33%) eyes that were taken care of with LI and 35 (40%) eyes that were handled with lensectomy. The suggest (SD) BSCVA of the study population was .09 (.43) logMAR, the indicate (SD) IOP was 12.6 (2.8) mm Hg, and the indicate ECD was 2200.00 (644.7) cells/mm2 at the final comply with-up.

IOL implantation was at the same time executed in 17 of 35 eyes (49%) immediately after lensectomy, with 15 undergoing in-the-bag fixation. Intraocular lens implantation was also executed in 17 of the remaining 18 eyes secondarily, with only 1 eye remaining aphakic (with out a lens). Bullous keratopathy designed in 1 eye just after LI, and glaucoma surgical procedures was desired in 7 eyes (8%).

There had been no substantial differences in BSCVA, IOP, or ECD among the procedure teams.

There were some limitations to this review. It did not assess ECD in all eyes, and the abide by-up time and observation time period have been relatively short. The etiology of APAC was not confirmed thanks to deficiency of pictures using anterior section optical coherence tomography or ultrasound biomicroscopy. The examine was performed retrospectively without having a regulate team, so a future controlled study in a much larger cohort would assist to confirm these outcomes.

The scientists concluded that their research demonstrated that a tiny much more than a quarter of eyes with APAC ended up settled following initial clinical treatment. The remaining individuals have been served by LI and lensectomy after preliminary healthcare treatment method.

“We believe that this information and facts will be clinically valuable for knowing the total prognosis of write-up-APAC people,” the authors wrote.


Iijima K, Kamiya K, Iida Y, Shoji N. Comparison of laser iridotomy and lensectomy outcomes for acute main angle closure. J Ophthalmol. Released on the web Might 30, 2022. doi:10.1155/2022/6959479