APACGAcute Primary Angle-Closure Glaucoma
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Patients with PACG associated with RP had almost the same biometric parameter characteristic as the patients with CPACG and APACG. Patients with APACG associated with RP had a significantly greater LT than patients with APACG (P < 0.05), a phenomenon that we attributed to measuring errors during the ultrasound examination.
In conclusion, patients with PACG associated with RP had the same biometric parameter characteristic as the patients with CPACG and APACG. This may suggest that RP has a coincidental relationship with angle-closure glaucoma.
Abbreviations RP: Retinitis pigmentosa PACG: Primary angle-closure glaucoma UBM: Ultrasound biomicroscopy ACD: Anterior chamber depth LT: Lens thickness AL: Axial length CPACG: Chronic primary angle-closure glaucoma APACG: Acute primary angle-closure glaucoma RLP: Relative lens position IOP: Intraocular pressure.
APACG was defined as patients who had typical symptoms of severe eye pain, conjunctival hyperemia, headache, tearing, blurred vision and/or seeing colored rings around lights and occasional nausea and vomiting with typical signs of microcystic corneal edema, narrow anterior chamber, middilated pupilla, intraocular pressure in the range of 50-60 mmHg and sometimes glaucomflecken.
CPACG was defined as an eye that had closed angles on gonioscopy that could or could not be opened with indentation gonioscopy and no history of APACG symptoms.
Consecutive APACG and CPACG patients were offered phacoemulsification surgery irrespective of lens opacity, visual acuity, extent of peripheral anterior synechiae, the state of IOP control or presence of peripheral iridotomy/iridectomy.
Of these, 22 eyes of 20 patients had APACG and 31 eyes of 23 patients had CPACG.
In APACG group, mean IOP (95% CI) at the first application to the outpatient clinic, at the last preoperative evaluation and at the last follow-up were 47.0 [+ or -] 13.5 mmHg (41.0-53.0), 30.9 [+ or -] 15.6 mmHg (23.0-38.0) and 15.5 [+ or -] 3.9 mm Hg (13.8-17.0) respectively.
Figure 1 compares IOP at the last preoperative evaluation to that of at the last follow-up in both APACG and CPACG groups.
Some patients in the APACG group were sent to our outpatient clinic through the emergency department, hence had no antiglaucoma medications while others were referred to us from neighboring hospitals after being provided medical care.
There were 4 eyes (18%) in the APACG group those were considered as failure where the failure criteria was an IOP >18mmHg despite antiglaucoma drops or need for glaucoma surgery.