Laser Peripheral Iridotomy Plus Laser Peripheral Iridoplasty for Primary Angle Closure

  • End date
    Apr 22, 2022
  • participants needed
  • sponsor
    Sun Yat-sen University
Updated on 22 January 2021


This is a 10-centre randomized controlled clinical trial to explore whether laser peripheral iridoplasty (LPIP) plus laser peripheral iridotomy (LPI) is more effective than single LPI to control the progression of primary angle closure with multi-mechanism based on the UBM classification.

Condition Angle Closure Glaucoma
Treatment neodymium:yttrium-aluminum- garnet laser, frequency-doubled Q-switched neodymium:yttrium-aluminum-garnet 532-nm laser, Pilocarpine, Pilocarpine, LPIP plus LPI, Proparacaine, LPI
Clinical Study IdentifierNCT02613013
SponsorSun Yat-sen University
Last Modified on22 January 2021


Yes No Not Sure

Inclusion Criteria

Clinical diagnosis of primary angle closure (PAC), with IOP30mmHg and PAS270
PAC with multi-mechanism based on UBM examination (multi-mechanism is defined as primary angle closure is caused by pupil block plus at least one kind of non-pupil block factors like (relative anterior position and thick of the ciliary body, the big volume of the iris, the anterior location of the iris insertion into the ciliary body)or any two or more kinds of combination
Visual acuity 20/40
Age between 40-75 years old Chinese people
If both eyes of a patient are eligible for the study, the e eye had worse
visual acuity will be selected. Only one eye per patient is eligible for the
Drug washout
Eligible patients who are already on anti-glaucoma medications are required to
have drug washout before being randomized. Various medications have different
washout periods: Prostaglandin analogues 4 weeks, Beta blockers 3 weeks
Adrenergic agonist 2 weeks, Cholinergic agonist 5 days, Carbonic Anhydrase
Inhibitors 5 days. Patients whose IOP>30 mm Hg during this washout period will
be stopped from further washout and be withdrawn from the study

Exclusion Criteria

Unwilling or unable to give consent, unwilling to accept randomization, or unable to return for scheduled protocol visits
Angle closure due to secondary causes (subluxed lens, neovascular, uveitic, traumatic, post-operative)
Previous incisional intraocular surgery or ocular laser in study eye (LPI or LPIP, cyclodestructive procedure, cataract surgery)
Primary angle closure with glaucomatous neuropathy
Have cataract in the studying eye and anticipated to have cataract surgery in the coming 3 years; the existing cataract affect visual field examination and fundus examination; the visual acuity <20/40 due to the existing cataract
Who are using IOP lowing drugs and do not have drug washout
Need for glaucoma surgery combined with other ocular procedures (i.e. cataract surgery, penetrating keratoplasty, or retinal surgery) or anticipated need for urgent additional ocular surgery
Coexisting other ocular diseases (i.e. cornea abnormal or cornea infection, Iridocorneal endothelial syndrome or anterior segment dysgenesis, nanophthalmos, high myopia (>6.0D), Chronic or recurrent uveitis, ocular cancer, trauma, central retinal vein occlusion, central retinal artery occlusion, retinal detachment)
cornea endothelium counting <1000/mm2
need local or systemic steroid long-term use
Unwilling to discontinue contact lens use after surgery
Who are taking parting in other drug clinical trials
Pregnant or nursing women
Severe systemic disease (i.e. diabetes mellitus, hypertension, the end stage of cardiac disease, nephropathy disease, respiratory disease and cancer
Allergic to pilocarpine or alcaine
Contraindication to ocular laser diseases
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