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M. Chen, J.C. Chou, C.J. Liu, S. Chou, W. Hsu; Long-term Clinical Course of Primary Angle-closure Glaucoma in a Chinese Population . Invest. Ophthalmol. Vis. Sci. 2003;44(13):81.
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Purpose: To investigate the long-term clinical course of patients with primary angle-closure glaucoma (PACG). Methods: The charts of 81 patients who were diagnosed as PACG and underwent laser peripheral iridectomy (LPI) from 1995 through 1999 were reviewed. PACG was defined as the presence of glaucomatous optic neuropathy and compatible visual field loss in the eye with a close angle. There were two groups of patients studied. Group A consisted of those with a past documented history of acute angle closure attack, which was treated with LPI. Group B consisted of those with no previous acute episode. (All patients were followed up at least 24 months.) The presenting feature, treatment and intraocular pressure during the follow-up period were analyzed. Results: The mean follow-up period was 44.6 ±20.1 months. There were 23 eyes (from 21 patients) in the Group A. The presenting IOP was 40 ±mmHg. Only one eye (4.3%) did not require any treatment after LPI in the long term. Nine eyes (40.9%) eventually underwent filtering surgery at a mean of 3.4 months after LPI. There were 97 eyes (from 60 patients) in the Group B. Seventeen eyes (17.5%) were successfully treated with LPI alone during the follow up. Eighty eyes (82.5%) required further medical treatment, of which 24 eyes (30%) eventually received filtering surgery at a mean of 11.9 months after LPI. Conclusions: In most Chinese eyes with PACG, LPI alone is not effective to control IOP in the long term. Filtering surgery is eventually required in some patients because of failed medical therapy, especially those with previous acute glaucoma attack.
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