Kenji Kashiwagi1, Shigeo Tsukahara. 1. Department of Ophthalmology, University of Yamanashi Faculty of Medicine, Tamaho, Japan. kenjik@yamanashi.ac.jp
Abstract
PURPOSE: To assess the present state of examination procedures and treatments for angle-closure glaucoma (ACG) in Japan. METHODS: A nationwide questionnaire survey was conducted, targeting 1237 registered facilities to Japanese Ophthalmological Society. RESULTS: Valid replies were obtained from 754 of 1232 facilities (61.2%). Primary ACG comprised a small percentage of the glaucoma types diagnosed in outpatient examinations. More than 50% of the laser iridotomy (LI) procedures were prophylactic at 52.9% of the facilities. Gonioscopy was most frequently used for determining indications for prophylactic LI. Specular microscopy was always performed prior to LI in 7.8% of the facilities. Prophylactic LI resulted in complications at 20.5% of the surveyed facilities, although the incidence was low. The following residual complications were reported at 82.9% of the facilities when treating ACG attacks: cataract, persistent elevation of intraocular pressure, and bullous keratopathy. One-third of the facilities experienced inadequate treatment of an ACG attack by physicians other than ophthalmologists. CONCLUSIONS: The incidence of LI-induced complications was higher in ACG eyes than in narrow-angle eyes. However, prophylactic LI sometimes results in persistent ocular complications.
PURPOSE: To assess the present state of examination procedures and treatments for angle-closure glaucoma (ACG) in Japan. METHODS: A nationwide questionnaire survey was conducted, targeting 1237 registered facilities to Japanese Ophthalmological Society. RESULTS: Valid replies were obtained from 754 of 1232 facilities (61.2%). Primary ACG comprised a small percentage of the glaucoma types diagnosed in outpatient examinations. More than 50% of the laser iridotomy (LI) procedures were prophylactic at 52.9% of the facilities. Gonioscopy was most frequently used for determining indications for prophylactic LI. Specular microscopy was always performed prior to LI in 7.8% of the facilities. Prophylactic LI resulted in complications at 20.5% of the surveyed facilities, although the incidence was low. The following residual complications were reported at 82.9% of the facilities when treating ACG attacks: cataract, persistent elevation of intraocular pressure, and bullous keratopathy. One-third of the facilities experienced inadequate treatment of an ACG attack by physicians other than ophthalmologists. CONCLUSIONS: The incidence of LI-induced complications was higher in ACG eyes than in narrow-angle eyes. However, prophylactic LI sometimes results in persistent ocular complications.
Authors: Leonard P K Ang; Hisayo Higashihara; Chie Sotozono; Vijay A Shanmuganathan; Harminder Dua; Donald T H Tan; Shigeru Kinoshita Journal: Br J Ophthalmol Date: 2007-06-13 Impact factor: 4.638