Behaviour of the fellow eye in acute angle-closure glaucoma.

Abstract

SUMMARY A retrospective study of 245 fellow eyes of patients admitted in primary acute angleclosure glaucoma (ACG) is presented. Twenty-five (10-2%) had acute ACG in the fellow eye on presentation. Of the remaining 220, 33 (15%) subsequently developed acute ACG before prophylactic surgery was performed. Possible predisposing factors were analysed. The main findings were that acute ACG in the fellow eye occurred most frequently in hospital, or during the first month after discharge if prophylactic surgery was not performed. The instillation of mydriatics in the operated eye increased the risk to the fellow eye. Pilocarpine and carbonic anhydrase inhibitors confer the best protection on the fellow eye, but no medical regimen entirely prevented an attack of acute ACG in the fellow eye.

New findings in the diagnosis and treatment of primary angle-closure glaucoma

“…A severe follow-up is required to avoid further attacks. The fellow eye of a patient with acute attack has a 40-80% chance of developing an acute attack within 5-10 years (Edwards, 1982;Lowe, 1966). A prophylactic laser iridotomy is therefore recommended.…”

Incidência de glaucoma agudo primário no Serviço de Glaucoma do Hospital São Geraldo

“…Alguns estudos documentaram a ocorrência de GAP no olho contralateral algum tempo após a eclosão da crise no olho inicialmente afetado (23)(24)(25) . Em trabalho realizado em 1962, constatou-se que, de 113 pacientes com GAP, 58 (51,3%) apresentaram crise no olho contralateral, sendo que, em um terço desses pacientes, a nova crise ocorreu um ano após a primeira (23) .…”

“…Em 1977, relatou-se que 43 (59,7%) de 72 pacientes não tratados com iridotomia a laser profilática desenvolveram GAP (24) . Em 1982 verificou-se que, de 245 pacientes com GAP, 25 (10,2%) apresentaram crises bilaterais no momento do diagnóstico, e dos 220 restantes, 33 (15%) pacientes desenvolveram crise no olho adelfo devido ao atraso de um mês para realização da profilaxia com laser (25) . Nenhum dos pacientes do presente estudo desenvolveu crise aguda de glaucoma no olho adelfo no período da pesquisa, uma vez que tratamento profilático era realizado o mais precocemente possível.…”

The role of lens extraction in the current management of primary angle-closure glaucoma

“…As pupil block is considered to be the primary mechanism for angle closure, laser peripheral iridotomy (LPI) is the first-line therapy of angle-closure management as it relieves pupil block and widens the angle [3][4][5]. Studies have shown that LPI does not open up the angles in all patients, and persistent elevations in IOP in the presence of a patent LPI have been reported [5,6].…”