Combined subconjunctival injection of dexamethasone for the management of acute primary angle closure: a randomised controlled trial.
Huang Wenbin, Li Xingyi, Gao Kai, Zhang Xiulan
AI Summary
Subconjunctival dexamethasone for acute angle closure accelerated IOP reduction and improved treatment success within 24 hours, suggesting it's a beneficial adjunct therapy.
Abstract
Purpose
To investigate whether the combined subconjunctival injection of dexamethasone can accelerate the decrease in intraocular pressure (IOP) in acute primary angle closure (APAC)-affected eyes.
Methods
42 patients with APAC were recruited for a randomised controlled trial. These patients were separated into two groups: the injection group (21 patients) and the control group (21 patients). The injection group was subjected to a subconjunctival injection with 2.5 mg dexamethasone. Other drug treatments were the same with the control group. The follow-up was at 0, 3, 6, 12 and 24 hours after injection. The outcome measures include IOP and intraocular inflammation variables.
Results
The IOP was significantly decreased in both groups after treatment. However, 24 hours after the initial treatment, the IOP of the injection group was significantly lower compared with the control group (p = 0.017). Kaplan-Meier survival curve analysis showed that the total success rate of the injection group and the control group were 79.7% and 54.9% at 24 hours after treatment (p = 0.027), respectively. For the comparison of anterior chamber inflammation, the severity of conjunctival erythema, ciliary flush and pain in the injection group was also lower than that in the control group at 24 hours after treatment(p = 0.012, p = 0.048 and p = 0.013, respectively). No statistical significance was found between the two groups regarding the anterior chamber cells, anterior chamber flare and photophobia.
Conclusion
The combined subconjunctival injection of dexamethasone for the management of APAC eyes can significantly accelerate the relief of high IOP, and therefore, improve the success rate of treatment.
MeSH Terms
Shields Classification
Key Concepts4
The combined subconjunctival injection of dexamethasone for the management of acute primary angle closure (APAC) eyes significantly accelerated the relief of high intraocular pressure (IOP) and improved the success rate of treatment.
In a randomized controlled trial of 42 patients with acute primary angle closure (APAC), 24 hours after initial treatment, the intraocular pressure (IOP) of the injection group (subconjunctival injection with 2.5 mg dexamethasone) was significantly lower compared with the control group (p = 0.017).
In a randomized controlled trial of 42 patients with acute primary angle closure (APAC), the total success rate of the injection group (subconjunctival injection with 2.5 mg dexamethasone) and the control group were 79.7% and 54.9% at 24 hours after treatment (p = 0.027), respectively.
In a randomized controlled trial of 42 patients with acute primary angle closure (APAC), the severity of conjunctival erythema, ciliary flush, and pain in the injection group (subconjunctival injection with 2.5 mg dexamethasone) was lower than that in the control group at 24 hours after treatment (p = 0.012, p = 0.048, and p = 0.013, respectively).
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