Le glaucome aigu primitif par fermeture de l'angle : aspects evolutifs et therapeutiques (a propos de 60 patients)‎

الملخص FRE

The acute closed angle glaucoma results from an anatomical predisposition.

It represents 10 to 30% of glaucomas.

The goal of our study is to highlight the various characters of the crisis and to specify the methods and the therapeutic indications.

Our study retrospective concerning 60 patients (60 eyes) seen between January 2000 and July 2007 for acute crisis of closed angle glaucoma.

The medical treatment was an intravenous perfusion of mannitol 20%, Acétazolamide per os (750 mg per day), a non steroidal eye drops and a beta blocking eye drops.

RESULTS : The average age was 58 years.

A female prevalence was noted.

The initial visual acuity varied between luminous perception and 5/10.

Ocular pressure varied between 28 and 66 mm Hg.

After resolution of the crisis under medical treatment (45 patients) curative iridectomy were performed.

A trabeculectomy was indicated for 18 patients for failure of standardization of intraocular pressure.

A peripheral iridectomy was performed for all the patients in the controlateral eye.

The risk of blindness by acute closed angle glaucoma in absence of treatment is very high.

A filterating surgery is indicated in front of a failure of standardization of intraocular pressure.

A preventive treatment of the controlateral eye is necessary because the important risk of bilateralisation.