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Spine Mar 2016A case report and literature review is presented of a patient that developed acute angle-closure glaucoma (AACG) after undergoing spine surgery in the prone position. (Review)
Review
STUDY DESIGN
A case report and literature review is presented of a patient that developed acute angle-closure glaucoma (AACG) after undergoing spine surgery in the prone position.
OBJECTIVES
To report a case of AACG after undergoing spine surgery in the prone position and describe potential causes and implications for future care.
SUMMARY OF BACKGROUND DATA
Visual loss is a devastating complication after spine surgery and is most often due to ischemic optic neuropathy. Although far less common, three cases of AACG have previously been reported, all of which were bilateral. Mydriatric agents and prone positioning were hypothesized as precipitating factors as both are known to increase intraocular pressure. In contrast to other visual loss diseases after spine surgery, AACG is amenable to treatment if recognized and treated early; however, its diagnosis is often complicated by patients presenting days after surgery. We report the case of a 65-year-old male who underwent multilevel revision spine surgery in the prone position and developed unilateral AACG after discharge on postoperative day 5.
METHODS
The case report is described. A literature review was performed using PubMed and keywords. The resulting articles were evaluated and references checked for additional cases.
RESULTS
The case herein resulted in no vision loss after the AACG was treated with laser iridotomy. The patient had a history of ocular issues in the affected side, highlighting the potential role anatomy plays in the development of AACG following spine surgery. Three reports of AACG were found after the literature review was performed.
CONCLUSION
Although it is not practical to screen all patients through ophthalmologic referral, there may be a role for targeted preoperative screening of patients with risk factors for AACG.
LEVEL OF EVIDENCE
5.
Topics: Aged; Glaucoma, Angle-Closure; Humans; Lumbar Vertebrae; Male; Postoperative Complications; Reoperation; Spinal Fusion; Spinal Stenosis
PubMed: 26571166
DOI: 10.1097/BRS.0000000000001224 -
Clinical & Experimental Ophthalmology Aug 2015Single nucleotide polymorphisms (SNPs) rs11024102 in PLEKHA7 and rs3753841 in COL11A1 were identified to be associated with primary angle closure glaucoma (PACG) by a... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Single nucleotide polymorphisms (SNPs) rs11024102 in PLEKHA7 and rs3753841 in COL11A1 were identified to be associated with primary angle closure glaucoma (PACG) by a recent large genome-wide association study. This present study is to evaluate the association of PLEKHA7 rs11024102 and COL11A1 rs3753841 with PACG.
DESIGN
A systematic review and meta-analysis.
PARTICIPANTS
A total of 25 271 subjects (4895 PACG patients and 20 376 controls) in different ethnicities were tested for PLEKHA7 rs11024102 and COL11A1 rs3753841.
METHODS
A comprehensive literature search was conducted on studies published up to July 2014. Summary odds ratios (ORs) and 95% confidence intervals were analysed. Publication bias of the included articles was evaluated using funnel plots and Egger's test.
MAIN OUTCOME MEASURES
OR for the effects of PLEKHA7 rs11024102 and COL11A1 rs3753841 on PACG risk.
RESULTS
Four eligible articles were included in this study for meta-analysis. The overall result showed that SNPs rs11024102 and rs3753841 were statistically associated with PACG (P < 0.001) in fixed-effects model. Stratified analyses showed that the association of PLEKHA7 rs11024102 and COL11A1 rs3753841 with PACG was statistically significant in Asian population (including South Indian cohort) (P < 0.001). In Caucasian population, significant association of COL11A1 rs3753841 with PACG was detected (P = 0.004), but PLEKHA7 rs11024102 did not show any association with PACG (P = 0.140).
CONCLUSIONS
This meta-analysis suggests that PLEKHA7 rs11024102 is associated with PACG in Asian population and COL11A1 rs3753841 has a genetic association with the development of PACG both in Caucasian and Asian populations.
Topics: Asian People; Carrier Proteins; Case-Control Studies; Collagen Type XI; Genetic Association Studies; Genetic Predisposition to Disease; Glaucoma, Angle-Closure; Humans; Odds Ratio; Polymorphism, Single Nucleotide; Risk Factors; White People
PubMed: 25732101
DOI: 10.1111/ceo.12516 -
[Zhonghua Yan Ke Za Zhi] Chinese... May 2017To evaluate the rate of blindness caused by primary angle closure glaucoma (PACG) in Chinese population of more than 40 years old, and to explore the effectiveness of a... (Meta-Analysis)
Meta-Analysis Review
To evaluate the rate of blindness caused by primary angle closure glaucoma (PACG) in Chinese population of more than 40 years old, and to explore the effectiveness of a prevention and treatment system on PACG. We searched the databases of Pubmed, ScienceDirect, Springer Link, CNKI and Wanfang Data and collected all the original studies of the prevalence and blindness of angle closure glaucoma in China. The population was limited to over 40 years old. The research site was limited to the community-based, while the published time was not limited. Two researchers completed the literature search, data extraction and methodological quality assessment independently, with same criteria. Meta analysis was performed using R software. Five papers were included in this study finally. A total of 26 437 cases of natural population over the age of 40 were observed, and 306 cases of angle closure glaucoma were found, of which 113 cases had binocular or monocular blindness caused by PACG. The random effect model meta-analysis results showed that the overall blindness rate was 38.3% [95% (28.1%, 49.6%)]. In Beijing, where the prevention and treatment system was well established, the blindness rate was far lower than that in the areas where the system was poorly established. Compared with the past, the blindness rate caused by PACG in Beijing decreased sharply. The rate of blindness caused by PACG is still high in the mainland of China. The prevention and treatment system is effective and worth promoting. -.
Topics: Adult; Aged; Asian People; Beijing; Blindness; China; Databases, Factual; Female; Glaucoma, Angle-Closure; Humans; Male; Middle Aged; Prevalence; Rural Population; Software
PubMed: 28494566
DOI: 10.3760/cma.j.issn.0412-4081.2017.05.010 -
The British Journal of Ophthalmology Sep 2012To estimate the prevalence of primary angle closure glaucoma (PACG) in European derived populations. (Review)
Review
AIM
To estimate the prevalence of primary angle closure glaucoma (PACG) in European derived populations.
METHOD
Systematic review and modelling of PACG prevalence data from population studies. PACG was defined according to the ISGEO definition requiring structural and/or functional evidence of glaucomatous optic neuropathy. Prevalence estimates were applied to the 2010 United Nations projected population figures to estimate case numbers.
RESULTS
The prevalence of PACG in those 40 years or more is 0.4% (95% CI 0.3% to 0.5%). Age-specific prevalence values are 0.02% (CI 0.00 to 0.08) for those 40-49 years, 0.60% (0.27 to 1.00) for those 50-59 years, 0.20% (0.06 to 0.42) for those 60-69 years and 0.94% (0.63 to 1.35) for those 70 years and older. Three-quarters of all cases occur in female subjects (3.25 female to 1 male; CI 1.76 to 5.94).
CONCLUSION
This analysis provides a current evidence-based estimate of PACG prevalence in European derived populations and suggests there are 130,000 people in the UK, 1.60 million people in Europe and 581,000 people in the USA with PACG today. Accounting for ageing population structures, cases are predicted to increase by 19% in the UK, 9% in Europe and 18% in the USA within the next decade. PACG is more common than previously thought, and all primary glaucoma cases should be considered to be PACG until the anterior chamber angle is shown to be open on gonioscopy.
Topics: Glaucoma, Angle-Closure; Global Health; Humans; Prevalence; White People
PubMed: 22653314
DOI: 10.1136/bjophthalmol-2011-301189 -
Medicine Oct 2019The aim of this meta-analysis is to compare the efficacy and safety of combined phacoemulsification (Phaco) with goniosynechialysis (GSL) to either Phaco or to Phaco... (Meta-Analysis)
Meta-Analysis
Systematic Review and Meta-Analysis of Comparing Phacoemulsification Combined with goniosynechialysis to other mainstream procedures in treating patients with angle-closure glaucoma.
BACKGROUND
The aim of this meta-analysis is to compare the efficacy and safety of combined phacoemulsification (Phaco) with goniosynechialysis (GSL) to either Phaco or to Phaco combined with trabeculectomy or trabeculectomy alone in patients with angle closure glaucoma (ACG).
METHODS
Five main electronic databases were searched for the eligible studies. Intraocular pressure (IOP) decrease was set as the primary outcome, while anti-glaucomatous medication decrease, changes of anterior chamber depth (ACD), range of peripheral anterior synechia (PAS), and complication occurrence were the secondary outcomes. Standard mean difference (SMD) and relative risk (RR) were the size effects for continuous and binomial data, respectively. Either fixed-effects model or random-effects model was chosen to pool the data based on the heterogeneities.
RESULTS
A total of 7 eligible studies were included. The combined data showed the IOP decreased more significantly after Phaco-GSL than that after Phaco alone (SMD = -0.42,95%CI: -0.70 - 0.14, I = 17.6%, Z = 2.90, P = .004). However, there were no distinct differences regarding medication decrease (SMD = -0.25,95%CI: -0.70 - 0.21, I = 0%, Z = 1.06, P = 0.29), ACD, the range of PAS and complication occurrence rate when compared Phaco-GSL to Phaco. Moreover, Phaco-GSL was comparable to Phaco-trabeculectomy/trabeculectomy in decreasing IOP (SMD = -0.08, 95%CI = -0.32 - 0.15, I = 0%, Z = 0.70, P = .49).
CONCLUSIONS
Phaco-GSL might be an optimal procedure to treat ACG with concomitant cataract due to its bleb-less nature, and its capacity for lowering IOP seems superior to Phaco alone and comparable to Phaco-trabeculectomy/trabeculectomy.
Topics: Cataract; Ciliary Body; Glaucoma, Angle-Closure; Humans; Intraocular Pressure; Phacoemulsification; Trabeculectomy; Visual Acuity
PubMed: 31626152
DOI: 10.1097/MD.0000000000017654 -
PloS One 2016Chronic glaucoma is a multifactorial disease among which oxidative stress may play a major pathophysiological role. We conducted a systematic review and meta-analysis to... (Meta-Analysis)
Meta-Analysis Review
Chronic glaucoma is a multifactorial disease among which oxidative stress may play a major pathophysiological role. We conducted a systematic review and meta-analysis to evaluate the levels of oxidative and antioxidative stress markers in chronic glaucoma compared with a control group. The PubMed, Cochrane Library, Embase and Science Direct databases were searched for studies reporting oxidative and antioxidative stress markers in chronic glaucoma and in healthy controls using the following keywords: "oxidative stress" or "oxidant stress" or "nitrative stress" or "oxidative damage" or "nitrative damage" or "antioxidative stress" or "antioxidant stress" or "antinitrative stress" and "glaucoma". We stratified our meta-analysis on the type of biomarkers, the type of glaucoma, and the origin of the sample (serum or aqueous humor). We included 22 case-control studies with a total of 2913 patients: 1614 with glaucoma and 1319 healthy controls. We included 12 studies in the meta-analysis on oxidative stress markers and 19 on antioxidative stress markers. We demonstrated an overall increase in oxidative stress markers in glaucoma (effect size = 1.64; 95%CI 1.20-2.09), ranging from an effect size of 1.29 in serum (95%CI 0.84-1.74) to 2.62 in aqueous humor (95%CI 1.60-3.65). Despite a decrease in antioxidative stress marker in serum (effect size = -0.41; 95%CI -0.72 to -0.11), some increased in aqueous humor (superoxide dismutase, effect size = 3.53; 95%CI 1.20-5.85 and glutathione peroxidase, effect size = 6.60; 95%CI 3.88-9.31). The differences in the serum levels of oxidative stress markers between glaucoma patients and controls were significantly higher in primary open angle glaucoma vs primary angle closed glaucoma (effect size = 12.7; 95%CI 8.78-16.6, P < 0.001), and higher in pseudo-exfoliative glaucoma vs primary angle closed glaucoma (effect size = 12.2; 95%CI 8.96-15.5, P < 0.001). In conclusion, oxidative stress increased in glaucoma, both in serum and aqueous humor. Malonyldialdehyde seemed the best biomarkers of oxidative stress in serum. The increase of some antioxidant markers could be a protective response of the eye against oxidative stress.
Topics: Aged; Aqueous Humor; Biomarkers; Case-Control Studies; Chronic Disease; Female; Glaucoma, Angle-Closure; Glaucoma, Open-Angle; Glutathione Peroxidase; Humans; Male; Malondialdehyde; Middle Aged; Oxidative Stress; Superoxide Dismutase
PubMed: 27907028
DOI: 10.1371/journal.pone.0166915 -
The Cochrane Database of Systematic... Jul 2006Angle-closure glaucoma is characterized by obstruction to the outflow of aqueous humor and consequent rise in intraocular pressure. The obstruction may result from an... (Review)
Review
BACKGROUND
Angle-closure glaucoma is characterized by obstruction to the outflow of aqueous humor and consequent rise in intraocular pressure. The obstruction may result from an anatomical predisposition of the eye or may be due to pathophysiologic processes in any part of the eye. The former is considered the primary form and the latter a secondary form of angle closure. Relative pupillary block obstructing free flow of aqueous from the posterior chamber of the eye to the anterior chamber is considered to be the most common mechanism of angle closure. Crowding of the angle is another mechanism, which often coexists with pupillary block. This can result from an anterior placement of the lens due to an increase in the thickness of the lens (as occurs with aging), anterior displacement by a posterior force (for example choroidal effusion), or laxity of the zonules.
OBJECTIVES
The objective of this review was to assess the effectiveness of lens extraction for chronic primary angle-closure glaucoma compared with other interventions for the condition in people without past history of acute-angle closure attacks.
SEARCH STRATEGY
We searched CENTRAL (2005, Issue 3), MEDLINE (1950 to April 2006), EMBASE (1980 to April 2006), and LILACS (to August 2005). We searched the reference lists of included studies and used the Science Citation Index database.
SELECTION CRITERIA
In the absence of any randomized trials we included non-randomized studies comparing lens extraction with other treatment modalities for chronic primary angle-closure glaucoma including, but not limited to, laser iridotomy, medications, and laser iridoplasty. We excluded studies with a case-series design.
DATA COLLECTION AND ANALYSIS
Two authors independently extracted data on methodological quality of the included studies, outcomes for the review, and study characteristics including participant characteristics, interventions, and sources of funding. Differences were resolved through discussion.
MAIN RESULTS
We found no randomized trials evaluating the effects of lens extraction as a treatment for chronic primary angle-closure glaucoma. Two non-randomized comparative studies included in the review have several methodological flaws including selection bias. While these studies and other non-comparative studies provide information on biological plausibility and treatment effect they do not provide proof of effectiveness. Also, they do not address the question of how primary lens extraction compares with other treatments for chronic primary angle-closure glaucoma.
AUTHORS' CONCLUSIONS
There is no evidence from good quality randomized trials or non-randomized studies of the effectiveness of lens extraction for chronic primary angle-closure glaucoma.
Topics: Chronic Disease; Glaucoma, Angle-Closure; Humans; Lens, Crystalline
PubMed: 16856103
DOI: 10.1002/14651858.CD005555.pub2 -
The Cochrane Database of Systematic... Jan 2023Primary angle-closure glaucoma is a type of glaucoma associated with a physically obstructed anterior chamber angle. For example, contact between the iris and lens at... (Review)
Review
BACKGROUND
Primary angle-closure glaucoma is a type of glaucoma associated with a physically obstructed anterior chamber angle. For example, contact between the iris and lens at the pupillary margin creates a pupillary block that increases resistance to aqueous outflow. Obstruction of the anterior chamber angle blocks drainage of fluids (aqueous humor) within the eye and may raise intraocular pressure (IOP). Elevated IOP is associated with glaucomatous optic nerve damage and visual field loss. Laser peripheral iridotomy ('iridotomy') is a procedure to eliminate pupillary block by allowing aqueous humor to pass directly from the posterior to anterior chamber, which is achieved by creating a hole in the iris using laser. Iridotomy is used to treat patients with primary angle-closure glaucoma, patients with primary angle-closure (narrow angles and no signs of glaucomatous optic neuropathy), and patients who are primary angle-closure suspects (patients with reversible obstruction). However, the effectiveness of iridotomy on slowing progression of visual field loss is uncertain.
OBJECTIVES
To assess the effects of iridotomy compared with no iridotomy for primary angle-closure glaucoma, primary angle-closure, and primary angle-closure suspect.
SEARCH METHODS
We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2021, Issue 10), which contains the Cochrane Eyes and Vision Trials Register; MEDLINE Ovid; Embase Ovid; PubMed; LILACS; ClinicalTrials.gov; and the WHO ICTRP. The date of the most recent search was 10 October 2021.
SELECTION CRITERIA
Randomized or quasi-randomized controlled trials that compared iridotomy with no iridotomy in primary angle-closure suspects, people with primary angle-closure, or people with primary angle-closure glaucoma in one or both eyes were eligible.
DATA COLLECTION AND ANALYSIS
We used standard Cochrane methodology and assessed the certainty of the body of evidence for prespecified outcomes using the GRADE approach.
MAIN RESULTS
We identified four studies (3086 eyes of 1543 participants) that compared iridotomy with no iridotomy in participants (range of mean age 59.6 to 62.9 years) who were primary angle-closure suspects from China, Singapore, or the UK. Study investigators randomized one eye of each participant to iridotomy and the other to no iridotomy. Two studies provided long-term (five or more years) results. We judged the certainty of the evidence as moderate to low across the prespecified outcomes, downgrading for high risk of bias (e.g. performance and detection biases) and imprecision of results. Meta-analyses of data from two studies suggest that iridotomy probably results in little to no difference in IOP compared with no iridotomy at one year (mean difference (MD) 0.04 mm Hg, 95% confidence interval (CI) -0.17 to 0.24; I = 65%; 2598 eyes of 1299 participants; moderate certainty evidence) and five years (MD 0.12 mm Hg, 95% CI -0.11 to 0.35; I = 0%; 2016 eyes of 1008 participants), and in best-corrected visual acuity measured as logMAR at one year (MD 0.00, 95% CI -0.01 to 0.01; I = 69%; 2596 eyes of 1298 participants; moderate certainty evidence) and five years (MD 0.01, 95% CI -0.01 to 0.03; I = 0%; 2002 eyes of 1001 participants). In terms of gonioscopic findings, eyes treated with iridotomy likely had wider angles in Shaffer grading scale (MD 4.93 units, 95% CI 4.73 to 5.12; I = 59%; 2598 eyes of 1299 participants at one year; MD 5.07, 95% CI 4.78 to 5.36; I = 97%; 2016 eyes of 1008 participants at five years; moderate certainty evidence) and experienced fewer peripheral anterior synechiae (PAS) than eyes that received no iridotomy at five years (risk ratio (RR) 0.41, 95% CI 0.24 to 0.67; I = 28%; 2 studies, 2738 eyes of 1369 participants), but the evidence was less conclusive at one year (RR 0.62, 95% CI 0.25 to 1.54; I = 57%; 3 studies, 2896 eyes of 1448 participants; low certainty evidence). No studies reported data on the proportion of participants with progressive visual field loss during follow-up (the primary outcome of this review), mean number of medications to control IOP, or quality of life outcomes. Low certainty evidence suggests that iridotomy may result in little to no difference in the incidence of acute angle-closure (RR 0.29, 95% CI 0.07 to 1.20; I = 0%; 3 studies, 3006 eyes of 1503 participants). Other ocular adverse events (e.g. eye pain, dry eye, redness of eyes, and ocular discomfort), although rare, were more common in eyes treated with iridotomy than in eyes in the control group. AUTHORS' CONCLUSIONS: We did not find sufficient evidence to draw any meaningful conclusions on the use of iridotomy for the purpose of slowing progression of visual field loss. No study reported on progressive visual field loss, the primary outcome of this review. Although there is moderate certainty evidence that iridotomy results in improved gonioscopic findings, in is unclear if these findings translate to clinically meaningful benefits.
Topics: Humans; Middle Aged; Glaucoma, Angle-Closure; Visual Fields; Quality of Life; Glaucoma; Intraocular Pressure; Vision Disorders
PubMed: 36621864
DOI: 10.1002/14651858.CD012270.pub3 -
Journal of Clinical Medicine Feb 2024To investigate the relationship between glaucoma, pseudoexfoliation and hearing loss (HL). : A systematic literature search following PRISMA guidelines was conducted... (Review)
Review
To investigate the relationship between glaucoma, pseudoexfoliation and hearing loss (HL). : A systematic literature search following PRISMA guidelines was conducted using the PubMed, Embase, Scopus and Cochrane databases from 1995 up to 28 August 2023. : Thirty studies out of the 520 records screened met the inclusion criteria and were included. Most articles (n = 20) analysed the association between pseudoexfoliation syndrome (XFS) and HL, showing XFS patients to have higher prevalence of sensorineural hearing loss (SNHL) at both speech frequencies (0.25, 0.5, 1 and 2 kHz), and higher frequencies (4 and 8 kHz) compared to controls in most cases. No significant differences in prevalence or level of HL between XFS and pseudoexfoliative glaucoma (XFG) were detected in most studies. Eight articles analysed the relationship between primary open-angle glaucoma (POAG) and HL. Overall, a positive association between the two conditions was highlighted across all studies except for two cases. Similarly, articles focusing on NTG and HL (n = 4) showed a positive association in most cases. The role of autoimmunity and, in particular, the presence of antiphosphatidylserine antibodies (APSA) in patients with NTG and HL suggested an underlying autoimmune or vascular mechanism contributing to their pathogenesis. Only one study analysed the relationship between angle-closure glaucoma (ACG) and HL, showing higher incidence of ACG in patients with SNHL compared to normal hearing controls. : Most studies detected an association between XFS and HL as well as POAG/NTG/ACG and HL, suggesting the presence of a similar pathophysiology of neurodegeneration. However, given the strength of the association of XFS with HL, it remains unclear whether the presence of XFG is further associated with SNHL. Further research specifically targeted to assess the correlation between glaucoma, XFS and HL is warranted to provide a more comprehensive understanding of this association.
PubMed: 38592217
DOI: 10.3390/jcm13051379 -
The Cochrane Database of Systematic... Jun 2018Primary angle-closure glaucoma is a type of glaucoma associated with a physically obstructed anterior chamber angle. Obstruction of the anterior chamber angle blocks... (Review)
Review
BACKGROUND
Primary angle-closure glaucoma is a type of glaucoma associated with a physically obstructed anterior chamber angle. Obstruction of the anterior chamber angle blocks drainage of fluids (aqueous humor) within the eye and may raise intraocular pressure (IOP). Elevated IOP is associated with glaucomatous optic nerve damage and visual field loss. Laser peripheral iridotomy (often just called 'iridotomy') is a procedure to eliminate pupillary block by allowing aqueous humor to pass directly from the posterior to anterior chamber through use of a laser to create a hole in the iris. It is commonly used to treat patients with primary angle-closure glaucoma, patients with primary angle closure (narrow angles and no signs of glaucomatous optic neuropathy), and patients who are primary angle-closure suspects (patients with reversible obstruction). The effectiveness of iridotomy on slowing progression of visual field loss, however, is uncertain.
OBJECTIVES
To assess the effects of iridotomy compared with no iridotomy for primary angle-closure glaucoma, primary angle closure, and primary angle-closure suspects.
SEARCH METHODS
We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 9) which contains the Cochrane Eyes and Vision Trials Register; MEDLINE Ovid; Embase Ovid; PubMed; LILACS; ClinicalTrials.gov; and the ICTRP. The date of the search was 18 October 2017.
SELECTION CRITERIA
Randomized or quasi-randomized controlled trials that compared iridotomy to no iridotomy in primary angle-closure suspects, patients with primary angle closure, or patients with primary angle-closure glaucoma in one or both eyes were eligible.
DATA COLLECTION AND ANALYSIS
Two authors worked independently to extract data on study characteristics, outcomes for the review, and risk of bias in the included studies. We resolved differences through discussion.
MAIN RESULTS
We identified two trials (2502 eyes of 1251 participants) that compared iridotomy to no iridotomy. Both trials recruited primary angle suspects from Asia and randomized one eye of each participant to iridotomy and the other to no iridotomy. Because the full trial reports are not yet available for both trials, no data are available to assess the effectiveness of iridotomy on slowing progression of visual field loss, change in IOP, need for additional surgeries, number of medications needed to control IOP, mean change in best-corrected visual acuity, and quality of life. Based on currently reported data, one trial showed evidence that iridotomy increases angle width at 18 months (by 12.70°, 95% confidence interval (CI) 12.06° to 13.34°, involving 1550 eyes, moderate-certainty evidence) and may be associated with IOP spikes at one hour after treatment (risk ratio 24.00 (95% CI 7.60 to 75.83), involving 1468 eyes, low-certainty evidence). The risk of bias of the two studies was overall unclear due to lack of availability of a full trial report.
AUTHORS' CONCLUSIONS
The available studies that directly compared iridotomy to no iridotomy have not yet published full trial reports. At present, we cannot draw reliable conclusions based on randomized controlled trials as to whether iridotomy slows progression of visual field loss at one year compared to no iridotomy. Full publication of the results from the studies may clarify the benefits of iridotomy.
Topics: Disease Progression; Glaucoma, Angle-Closure; Humans; Intraocular Pressure; Iris; Randomized Controlled Trials as Topic; Time Factors; Vision Disorders; Visual Fields
PubMed: 29897635
DOI: 10.1002/14651858.CD012270.pub2