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New treatments evolving for acute primary angle-closure glaucoma
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NUSA DUA, Indonesia — Acute angle-closure glaucoma attacks require alternatives to conventional treatments, and a number of effective treatments are evolving, according to one speaker here.
 Dennis S.C. Lam |
Dennis S.C. Lam, MD, FRCOphth, said in a presentation at the joint meeting of the Asia-Pacific Academy of Ophthalmology and American Academy of Ophthalmology that because conventional therapeutic treatments for glaucoma fail to reduce IOP in 30% of acute attacks and 58% progress to closed-angle glaucoma, alternative treatments are necessary and a number have had promising results.
"Acute laser peripheral iridoplasty has been used very successfully in acute angle-closure that failed maximal medications," he said.
Immediate anterior chamber paracentesis may also be a good option because it does not require expensive equipment, surgeons are already familiar with the procedure, and it can immediately stabilize IOP and reduce nerve damage, he said.
A small case series has shown another possible but more difficult treatment is phacoemulsification performed during the time of attack. Prof. Lam said the procedure, because of its risky nature, is skill-dependent and may not be for all surgeons.