Examination and Treatment of Patients with Angle-Closure Glaucoma in Japan: Results of a Nationwide Survey

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. Jpn J Ophthalmol 2004;48:133–140 © Japanese Ophthalmological Society 2004