Objective. To quantitatively study the intraocular pressure (IOP) control and chamber angle opening degree of patients with acute angle-closure glaucoma (stage of attack) treated by laser peripheral iridoplasty (LPIP) with different numbers of laser shots, and to evaluate the efficacy and safety of different numbers of laser shots. Methods. Fifty-five patients (60 eyes) with acute angle-closure glaucoma treated in our hospital from May 2019 to December 2020 were selected as the research subjects. All patients had poor intraocular pressure control (≥40 mmHg) after IOP-lowering drug therapy. The patients were randomly divided into three groups, 20 eyes in each group, and underwent laser peripheral iridoplasty (LPIP) with different numbers of laser shots (group I: 35 laser shots, group II: 45 laser shots, and group III: 60 laser shots). The best-corrected visual acuity, IOP, corneal condition, and opening degree of anterior chamber angle (ACA), namely, the trabecular-iris angle (TIA), angle opening distance at 500 μm (AOD500), and complications of patients before LPIP, 2 hours after LPIP, and 24 hours after LPIP were observed, and the opening degree of ACA were quantitatively measured. Results. The corrected visual acuity of the three groups after LPIP was improved to varying degrees, and the IOP decreased, TIA and AOD500 were increased compared with those before operation, and the differences were statistically significant P < 0.05 . There were statistically significant differences between group II and group I P < 0.05 . Four eyes in group I underwent LPIP again due to increased IOP. In group III, iris hemorrhage occurred in one eye and iris depigmentation occurred in one eye, and there was no statistical difference compared with group II P > 0.05 . Conclusions. LPIP can effectively reduce preoperative IOP and increase ACA width in patients with persistent high IOP that failed to respond to drug therapy, and moderate numbers of laser shots can achieve satisfactory results and highest safety.
Age-related cataracts (ARC) are the leading cause of visual impairment and blindness, affecting 16 million subjects globally. This work aimed to investigate the correlation of serum homocysteine (Hcy), folate, vitamin B6 (VitB6) and ARC. We prospectively enrolled 60 ARC, and 58 age-matched healthy controls in this study. The serum concentrations of Hcy were determined using a fully automatic biochemical analyzer and folate/VitB6 by enzyme-linked immunosorbent assay (ELISA). The diagnostic performance of serum Hcy, folate and VitB6 for ARC were evaluated by receiver operating characteristics (ROC). The mean serum levels of Hcy, folate and VitB6 from the control group were 9.8 ± 2.1 μmol/L, 17.4 ± 2.3 nmol/L, 42.3 ± 5.7 pmol/L, respectively. In comparison, the mean serum levels of Hcy, folate and VitB6 from the ARC group were 12.2 ± 2.5 μmol/L, 15.3 ± 2.6 nmol/L, 40.3 ± 5.1 pmol/L, respectively. Significant statistical difference (p<0.05) were found between the control and ARC groups. The diagnostic sensitivity, specificity and AUC of serum Hcy as a biomarker for ARC were 53.1%, 76.3% and 0.66 (95% CI:0.61-0.76), respectively, which were superior to that of serum folate and VitB6. Serum Hcy was significantly elevated in ARC patients and correlated with ARC development, thus may be used as a serological marker for ARC diagnosis.
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