Comparing the Effectiveness of Laser Therapy, Medicaments and Surgical Treatment in Patients with Angle Closed Glaucoma

Abstract

The study goal was to compare the efficiency of the medicaments, laser and surgical treatment in the patients with primary angle closure glaucoma (PACG) in order to achieve: normalization of intraocular pressure (IOP), maintaining the useful visual acuity and stabilization of visual field loss. All patients were treated at Clinic of Ophthalmology of Clinical Centre Kragujevac in Kragujevac, Serbia, in the period from June 15, 2010 to June 15, 2014. There were 116 patients in this study. They diagnosed with PACG, and they had been adequate selected for this study. They were treated with: medicaments; Nd:YAG (Neodymium:Yittrium Aluminum Garnet) laser iridotomy, and glaucoma surgery. Clinical ophthalmology controls have been introduced once or twice a month, and the vision field loss was tested three times every year. During the monitoring period of one year: no statistically significant difference occurred in terms of changes of the visual acuity among the three study-groups. The best IOP regulation was achieved after the laser treatment (53.4%), followed by the surgical treatment (28.5%), while the weakest was recorded in patients treated with the medicaments (18.1%). The percentage of the visual field loss was the biggest of patients treated with the medicaments (57%), and then the patients treated with the laser iridotomy (35%), while the least one occurred of the patients with the surgical treatment (23%). In the laser-treated group of 62 patients, the frequency of complications was 17.8%; while the out of 33 patients who had been treated (surgical), the frequency of complications was 19%. Laser iridotomy was shown to be effective of 89.5% of study-patients with PACG, while non-reactive studypatients underwent to the trabeculectomy. In addition to the high efficacy of Nd:YAG laser iridotomy in regulating of IOP values of the patients with PACG, the advantage of laser-method was in: the maneuvering of outpatients, it was easy to do, had a short lead time and was used in local anesthesia.