Bayliss, James M, Ng, Wai Siene, Waugh, Norman and Azuara-Blanco, Augusto (2021) Laser peripheral iridoplasty for chronic angle closure. Cochrane Database of Systematic Reviews (3). CD006746. doi:10.1002/14651858.CD006746.pub4

PDF WRAP-laser-peripheral-iridoplasty-chronic-angle-closure-Waugh-2021.pdf - Published Version Embargoed item. Restricted access to Repository staff only until 23 March 2022. Contact author directly, specifying your specific needs. - Requires a PDF viewer. Download (414Kb)

Request Changes to record.

Abstract

Background
In at least a third of primary angle closure cases, appositional angle closure persists after laser peripheral iridotomy, and further intervention may be considered. Laser peripheral iridoplasty (LPIp) can be used in treating chronic angle closure when angle closure persists after laser peripheral iridotomy. Previous reviews have found insufficient data to determine its clinical effectiveness, compared to other interventions. This is an update of a Cochrane Review first published in 2008 and updated in 2012. It examines all studies to date to establish whether LPIp shows any effectiveness over other available treatment options.

Objectives
To assess the effectiveness of laser peripheral iridoplasty in the treatment of people with chronic angle closure, when compared to laser peripheral iridotomy, medical therapy or no further treatment.

Search methods
We searched various electronic databases. The date of the search was 20 December 2020.

Selection criteria
We included only randomised controlled trials (RCTs) assessing the use of LPIp in cases of suspected primary angle closure (PACS), confirmed primary angle closure (PAC), or primary chronic angle‐closure glaucoma (PACG). We applied no restrictions with respect to gender, age or ethnicity of participants. Trials evaluating LPIp for acute attacks of angle closure were not eligible.

Data collection and analysis
We used standard methodological procedures expected by Cochrane. Two authors independently assessed studies for risk of bias using Cochrane’s 'risk of bias' tool. We collected adverse effects information from the trials.

Main results
We included four RCTs involving 252 participants (276 eyes). In total, three different methods of intervention were used and 15 outcomes reported, with different time points. We used narrative synthesis to describe the majority of the findings, as meta‐analysis was only possible for a limited number of outcomes due to the variation in study design and outcomes assessed.

Authors' conclusions
After reviewing the outcomes of four RCTs, argon LPIp as an intervention may be no more clinically effective than comparators in the management of people with chronic angle closure. Despite a potential positive impact on anterior chamber morphology, its use in clinical practice in treating people with chronic angle closure is not supported by the results of trials published to date. Given these results, further research into LPIp is unlikely to be worthwhile.

Item Type:	Journal Article
Subjects:	R Medicine > R Medicine (General) R Medicine > RD Surgery R Medicine > RE Ophthalmology
Divisions:	Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Lasers in medicine, Eye -- Surgery, Angle-closure glaucoma, Glaucoma -- Treatment
Journal or Publication Title:	Cochrane Database of Systematic Reviews
Publisher:	Wiley
ISSN:	1469-493X
Official Date:	23 March 2021
Dates:	Date Event 23 March 2021 Published 1 February 2021 Accepted
Number:	3
Article Number:	CD006746
DOI:	10.1002/14651858.CD006746.pub4
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
RIOXX Funder/Project Grant:	Project/Grant ID RIOXX Funder Name Funder ID UNSPECIFIED [NIHR] National Institute for Health Research http://dx.doi.org/10.13039/501100000272

Request changes or add full text files to a record

Repository staff actions (login required)

View Item