The Singapore Asymptomatic Narrow Angles Laser Iridotomy Study
In: Ophthalmology, Jg. 129 (2022-02-01), S. 147-158
Online
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Purpose To examine the efficacy of laser peripheral iridotomy (LPI) in patients who received a diagnosis of primary angle-closure suspect (PACS). Design Prospective, randomized controlled trial. Participants This multicenter, randomized controlled trial ( ClinicalTrials.gov identifier, NCT00347178 ) enrolled 480 patients older than 50 years from glaucoma clinics in Singapore with bilateral asymptomatic PACS (defined as having ≥2 quadrants of appositional angle closure on gonioscopy). Methods Each participant underwent prophylactic LPI in 1 randomly selected eye, whereas the fellow eye served as a control. Patients were followed up yearly for 5 years. Main Outcome Measures The primary outcome measure was development of primary angle closure (PAC; defined as presence of peripheral anterior synechiae, intraocular pressure [IOP] of >21 mmHg, or both or acute angle closure [AAC]) or primary angle-closure glaucoma (PACG) over 5 years. Results Of the 480 randomized participants, most were Chinese (92.7%) and were women (75.8%) with mean age of 62.8 ± 6.9 years. Eyes treated with LPI reached the end point less frequently after 5 years (n = 24 [5.0%]; incidence rate [IR], 11.65 per 1000 eye-years) compared with control eyes (n = 45 [9.4%]; IR, 21.84 per 1000 eye-years; P = 0.001). The adjusted hazard ratio (HR) for progression to PAC was 0.55 (95% confidence interval [CI], 0.37–0.83; P = 0.004) in LPI-treated eyes compared with control eyes. Older participants (per year; HR, 1.06; 95% CI, 1.03–1.10; P Conclusions In patients with bilateral asymptomatic PACS, eyes that underwent prophylactic LPI reached significantly fewer end points compared with control eyes over 5 years. However, the overall incidence of PAC or PACG was low.
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The Singapore Asymptomatic Narrow Angles Laser Iridotomy Study
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Autor/in / Beteiligte Person: | Perera, Shamira A. ; Wong, Hon-Tym ; Friedman, David S. ; Kumar, Rajesh S. ; Aung, Tin ; Foster, Paul J. ; Lavanya, Raghavan ; Narayanaswamy, Arun ; Baskaran, Mani ; Paul T K Chew ; Lu, Qing-Shu |
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Zeitschrift: | Ophthalmology, Jg. 129 (2022-02-01), S. 147-158 |
Veröffentlichung: | Elsevier BV, 2022 |
Medientyp: | unknown |
ISSN: | 0161-6420 (print) |
DOI: | 10.1016/j.ophtha.2021.08.017 |
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