AIM: To investigate the effect and safety of laser peripheral iridoplasty combined with iridectomy in the unmanageable acute angle-closure glaucoma by medication.

METHODS: Totally 19 cases(21 eyes)with acute angle-closure glaucoma, including 15 cases(17 eyes)with primary glaucoma and 4 cases(4 eyes)with intumescent cataract-induced glaucoma, were recruited into the study. The intraocular pressure(IOP)of all cases were still >21mmHg after 24h drug treatment, and then were treated by laser peripheral iridoplasty combined with iridectomy. The visual accurity, IOP, cornea, peripheral anterior chamber depth, anterior chamber angle and complications were observed at 24h after the surgery.

RESULTS: The mean IOP of all cases was reduced from 53.09±11.01mmHg before the surgery to 14.98±4.21mmHg at 24h after the treatment, with significant statistical difference(P<0.01). The visual acurity of all cases increased in different degrees from handle move to 0.3 to 0.1-1.0 at 24h after the treatment. In all cases, cornea edema reduced or cleared up, peripheral anterior chamber depth increased, and anterior chamber angle reopened in different degrees. Complications included iris hemorrhage in 11 eyes(52.4%), mild iritis in 21 eyes(100%). No cornea burn was encountered.

CONCLUSION: Laser peripheral iridoplasty combined with iridectomy is an effective and safe method for the treatment of the unmanageable acute angle-closure glaucoma by medication.