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 las er peripheral iridoplasty (ALPI) as a first-line treatment for acute primar y angle closure glaucoma (PACG) without the use of systemic anti-glaucomato us medications. Methods Ten consecutive patients with PACG were recruited into the study. E ach patient received topical pilocarpine (4%) and timolol (0.5%), and immed iate 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 r educed 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 complicatio ns 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 aft er ALPI. Conclusion Immediate limited ALPI, without adjunctive systemic anti-glaucom atous medications, appeared to be effective and safe in controlling the IOP in treating acute PACG with a duration of attack less than or equal to 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.