A prospective longterm study of primary chronic angle closure glaucoma

. Purpose: To prospectively evaluate the longterm outcome of therapy for chronic primary angle closure glaucoma (PACG) and to assess the efficacy of medical and surgical treatment in terms of intraocular pressure (IOP) and visual field stabilization. Methods: Seventy consecutive patients with chronic PACG, whose IOP remained > 21 mmHg despite a patent iridotomy, had their IOP controlled by medications or trabeculectomy performed without antimetabolites. They were followed over a 6‐year period. Best corrected visual acuity, IOP (mean of annual diurnal variation readings), cup : disc ratio and visual fields were recorded. A trabeculectomy was performed if the IOP was not adequately controlled on maximal tolerable medical therapy or if there was a progression of the glaucomatous defect. Data from one eye of each patient were analysed; if both eyes met the inclusion criteria, one was randomly selected for the analysis. The baseline parameters were compared with those at the end of 6 years. Results: A total of 46 eyes (65%) were controlled medically throughout the 6‐year follow‐up period, while 24 eyes (35%) required surgery. The mean IOP was 25.4 ± 4.9 mmHg at baseline and 15.6 ± 4.6 mmHg at 6 years follow‐up (p