Management of chronic or intermittent primary angle-closure glaucoma: a long-term follow-up of the results of peripheral iridectomy used as an initial procedure.

Patients presenting with either intermittent closed-angle glaucoma which gave to subacute congestive attacks or with chronic angle-closure glaucoma were followed up over 12 years. Peripheral iridectomy was performed as a primary procedure on these patients during this period. It was found to be a highly effective procedure in those patients without field loss at the time of presentation, but because of the figures presented here we would recommend that any patient presenting with angle closure and disc and field changes should have a trabeculectomy performed as a primary procedure. We found no way of predicting which patients would require further surgery from the history, initial intraocular pressure, or the gonioscopic findings. No patient in this series developed malignant glaucoma after trabeculectomy although it occurred in 2 eyes after peripheral iridectomy.