Immediate Anterior Chamber Paracentesis With A 30-Gauge Needle for Acute Primary Angle - Closure

Siriraj Hospital

Status: Completed

Conditions: Glaucoma, Angle-closure

Treatments: Procedure: Paracentesis; Procedure: Peripheral iridotomy; Drug: Acetazolamide

Study type: Interventional

Funder types: Other

Identifiers

NCT01923454

NK001

Details and patient eligibility

About

This study was to evaluate the efficacy and safety of immediate anterior chamber paracentesis (ACP) with a 30-gauge needle as an initial treatment for acute primary angle closure (APAC).

Full description

This is a prospective study from patients with APAC presenting at the Faculty of Medicine Siriraj Hospital, Bangkok, Thailand in 2005. At presentation, patients received immediate ACP with a 30-gauge needle. The IOP, best corrected visual acuity (BCVA), corneal edema grading, pupil size and symptoms were recorded at immediately, 15 and 30 minutes, and then 1, 24 and 48 hours after paracentesis. All affected eyes received antiglaucomatous medications 60 minutes after ACP and underwent peripheral iridotomy within 24 hours.

Enrollment: 15 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• patients aged more than 18 year old with the first attack of APAC
• IOP of more than or equal to 40 mmHg.

Exclusion criteria

• patient unable to cooperate for paracentesis
• patients with APAC in the only remaining eye
• patients received any glaucoma treatments prior to the study
• patients with secondary causes of acute angle closure
• patients with intraocular inflammation or infection; (6) patients with APAC in the eye with a history of previous intraocular surgery
• patients known hypersensitive to tetracaine hydrochloride or tobramycin.

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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15 participants in 1 patient group

Paracentesis

Experimental group

Description:

Immediate anterior chamber paracentesis (ACP) with a 30-gauge needle as an initial treatment for acute primary angle closure. Acetamide, given in this study, is a standard treatment for acute angle-closure glaucoma. The participant will receive 1 tablet(250mg) at 1 hours after paracentesis. The following dose will be adjusted according to the level of IOP. The maximal dose is 4 tablets per day. It will be discontinued if the IOP is less than 21 mmHg. All affected eyes will receive laser peripheral iridotomy with 24 hours after presentation. This a standard treatment for Acute angle-closure glaucoma

Treatment:

Drug: Acetazolamide

Procedure: Peripheral iridotomy

Procedure: Paracentesis