AIM: To determine the factors associated with primary angle-closure(PAC)progression to glaucoma(PACG)after laser peripheral iridotomy(LPI)at baseline.

METHODS: This was a prospective cohort study. Subjects were consecutively enrolled among the patients with PAC at the ophthalmology clinic of our Hospital between January 2017 and December 2017. Among these 86 eyes of 86 PAC patients who fulfilled the inclusion criteria, 65 eyes of 65 patients who fulfilled the inclusion criteria of 5 or more VFs and 2 years or more of follow-up were selected. The mean follow-up period was 2.65±0.27 years. According to the occurrence of visual field defects and corresponding glaucomatous optic nerve damage, the patients were divided into the progressive group and the non-progressive group, and the correlative factors of PAC progression after LPI were analyzed in PAC patients.

RESULTS: PAC progression after LPI was observed in 9 of 65 eyes(14%). There were significant differences in age and inter-visit IOP fluctuations between the progressive group(68.67±7.03 years, 10.11±4.17mmHg)and the non-progressive group(61.95±8.03 years, 5.54±2.73mmHg)(P<0.05). The frequency of PAC progressing into PACG with VCDR≥0.6, PAS≥1 quadrants, all angle-closure>2 quadrants was significantly higher in the progressing eyes than in the non- progressing eyes(P<0.05). PAC progression was significantly positively correlated with age, inter-visit IOP fluctuations, VCDR≥0.6, PAS≥1 quadrants, and all angle-closure >2 quadrants(r_s=0.304, 0.396, 0.495, 0.268, 0.309).

CONCLUSION:PAC patients after LPI with PAS≥1 quadrants and all angle-closure >2 quadrants, VCDR≥0.6, older age,higher inter-visit IOP fluctuations were more likely to progress to glaucoma.