The new method for primary angle-closure glaucoma treatment: evolution of hypertensive efficacy in the long-term period

Purpose: to work out a new algorithm of primary angle closure glaucoma (PACG) treatment based on the two steps of treatment: peripheral laser iridotomy (PUT) and selective laser trabeculoplasty (SLT)- and evaluate its hypotensive and functional effect over the long term period. Material and Methods. SLT hypotensive efficiency was evaluated on the sample of 70 eyes with the initial PACG after PI performed not earlier than one month before SLT and in 75 eyes with initial POAG. The quantities of hypotensive medication, necessary for decreasing IOP >20%, were also considered. Rate of progression (ROP) was assessed using MD index, RNFL and GCC thickness. The follow-up period was 6 years. Results. IOP decreased significantly after SLT in both groups over the long-term period. Hypotensive effect was more pronounced in PACG - 38.5% compared to POAG - 28%. After 6 years, less hypotensive eye drops were required for achieving the hypotensive efficacy in PACG than in POAG (p=0.035). There was no significant difference in ROP between PACG and POAG (p=0.461). Conclusion. The developed method of consequent laser treatment of PACG leads to effective IOP reduction and preserves glaucoma progression that does not differ from POAG.