Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Feb 15;2012(2):CD006746.
doi: 10.1002/14651858.CD006746.pub3.

Laser peripheral iridoplasty for angle-closure

Wai Siene Ng  1 , Ghee Soon Ang, Augusto Azuara-Blanco
Affiliations

Laser peripheral iridoplasty for angle-closure

Wai Siene Ng et al. Cochrane Database Syst Rev. .

Update in

Abstract

Background: Angle-closure glaucoma is a leading cause of irreversible blindness in the world. Treatment is aimed at opening the anterior chamber angle and lowering the IOP with medical and/or surgical treatment (e.g. trabeculectomy, lens extraction). Laser iridotomy works by eliminating pupillary block and widens the anterior chamber angle in the majority of patients. When laser iridotomy fails to open the anterior chamber angle, laser iridoplasty may be recommended as one of the options in current standard treatment for angle-closure. Laser peripheral iridoplasty works by shrinking and pulling the peripheral iris tissue away from the trabecular meshwork. Laser peripheral iridoplasty can be used for crisis of acute angle-closure and also in non-acute situations.

Objectives: To assess the effectiveness of laser peripheral iridoplasty in the treatment of narrow angles (i.e. primary angle-closure suspect), primary angle-closure (PAC) or primary angle-closure glaucoma (PACG) in non-acute situations when compared with any other intervention. In this review, angle-closure will refer to patients with narrow angles (PACs), PAC and PACG.

Search methods: We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2011, Issue 12), MEDLINE (January 1950 to January 2012), EMBASE (January 1980 to January 2012), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to January 2012), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). There were no date or language restrictions in the electronic searches for trials. The electronic databases were last searched on 5 January 2012.

Selection criteria: We included only randomised controlled trials (RCTs) in this review. Patients with narrow angles, PAC or PACG were eligible. We excluded studies that included only patients with acute presentations, using laser peripheral iridoplasty to break acute crisis.

Data collection and analysis: No analysis was carried out as only one trial was included in the review.

Main results: We included one RCT with 158 participants. The trial reported laser peripheral iridoplasty as an adjunct to laser peripheral iridotomy compared to iridotomy alone. The authors report no superiority in using iridoplasty as an adjunct to iridotomy for IOP, number of medications or need for surgery.

Authors' conclusions: There is currently no strong evidence for laser peripheral iridoplasty's use in treating angle-closure.

PubMed Disclaimer

Conflict of interest statement

None known.

Update of

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

References to studies included in this review

Sun 2010 {published data only}
    1. Sun X, Liang YB, Wang NL, Fan SJ, Sun LP, Li SZ, et al. Laser peripheral iridotomy with and without iridoplasty for primary angle‐closure glaucoma: 1‐year results of a randomized pilot study. American Journal of Ophthalmology 2010;150(1):68‐73. - PubMed

Additional references

Agarwal 1991
    1. Agarwal HC, Kumar R, Kalra VK, Sood NN. Argon laser iridoplasty : a primary mode of therapy in primary angle closure glaucoma. Indian Journal of Ophthalmology 1991;39(3):87‐90. - PubMed
Deeks 2011
    1. Deeks JJ, Higgins JPT, Altman DG (editors). Chapter 9: Analysing data and undertaking meta‐analyses. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
Foster 1996
    1. Foster PJ, Baasanhu J, Alsbirk PH, Munkhbayer D, Uranchimeg D, Johnson GJ. Glaucoma in Mongolia ‐ a population‐based survey in Hovsgol Province, northern Mongolia. Archives of Ophthalmology 1996;114(10):1235‐41. - PubMed
Foster 2000
    1. Foster PJ, Oen FT, Machin DS, Ng TP, Devereux JG, Johnson GJ, et al. The prevalence of glaucoma in Chinese residents of Singapore. A cross‐sectional population survey in Tanjong Pagar district. Archives of Ophthalmology 2000;118(8):1105‐11. - PubMed
Foster 2001
    1. Foster PJ, Johnson GJ. Glaucoma in China: how big is the problem?. British Journal of Ophthalmology 2001;85(11):1277‐82. - PMC - PubMed
Higgins 2002
    1. Higgins JP, Thompson SG. Quantifying heterogeneity in a meta‐analysis. Statistics in Medicine 2002;21(11):1539‐58. - PubMed
Higgins 2011
    1. Higgins JPT, Altman DG, Sterne JAC (editors). Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
Lai 1999
    1. Lai JS, Tham CC, Lam DS. Limited argon laser peripheral iridoplasty as immediate treatment for an acute attack of primary angle closure glaucoma: a preliminary study. Eye 1999;13(Pt 1):26‐30. - PubMed
Lai 2000
    1. Lai JS, Tham CC, Chua JK, Lam DS. Efficacy and safety of inferior 180 degrees goniosynechialysis followed by diode laser peripheral iridoplasty in the treatment of chronic angle‐closure glaucoma. Journal of Glaucoma 2000;9(5):388‐91. - PubMed
Lam 1992
    1. Lam DS, Lai JS, Tham CC. Immediate argon laser peripheral iridoplasty as treatment for acute attack of primary angle‐closure glaucoma: a preliminary study. Ophthalmology 1998;105(12):2231‐36. - PubMed
Quigley 1996
    1. Quigley HA. Number of people with glaucoma worldwide. British Journal of Ophthalmology 1996;80(5):389‐93. - PMC - PubMed
Resnikoff 2004
    1. Resnikoff S, Pascolini D, Etya'ale D, Kocur I, Pararajasegaram R, Pokharel GP, et al. Global data on visual impairment in the year 2002. Bulletin of the World Health Organization 2004;82(11):844‐51. - PMC - PubMed
Ritch 2004
    1. Ritch R, Tham CC, Lam DS. Long‐term success of argon laser peripheral iridoplasty in the management of plateau iris syndrome. Ophthalmology 2004;111(1):104‐8. - PubMed
Sassani 1993
    1. Sassani JW, Ritch R, McCormick S, Liebmann JM, Eagle RC Jr, Lavery K, et al. Histopathology of argon laser iridoplasty. Ophthalmic Surgery 1993;24(11):740‐5. - PubMed
Weinreb 2006
    1. Weinreb RN, Friedman DS. Angle closure and angle closure glaucoma. The Hague, The Netherlands: Kugler Publications, 2006.

References to other published versions of this review

Ng 2008
    1. Ng WS, Ang GS, Azuara‐Blanco A. Laser peripheral iridoplasty for angle‐closure. Cochrane Database of Systematic Reviews 2008, Issue 3. [DOI: 10.1002/14651858.CD006746.pub2] - DOI - PubMed

Publication types