Clinical studies of primary angle closure glaucoma.

The ocular anatomic features, pupil-blocking force, status of angle synechia closure and positivity of provocative tests were compared between the primary chronic angle closure glaucoma (PCACG) and primary acute angle closure glaucoma (PAACG) by ultrasonic biometry, computerized image processing technique of the anterior ocular segment, gonioscopy and provocative tests. The studies showed that the anterior chamber depth of PAACG was shallower than that of PCACG, the pupil-blocking force of PAACG was stronger than that of PCACG, the status of angle synechia closure of PCACG was mainly creeping synechia closure and the positivity of mydriasis test after iridectomy was much higher (37.93%) in PCACG than that (11.43%) in PAACG. These facts suggested that the mechanisms of the angle closure of more than half of PCACG cases be multiple, besides the mechanism of pupillary block. Therefore, the authors emphasize that the pupillary block must be eliminated as well as the other mechanisms for the treatment of PCACG. The criteria of diagnosis and principles of management of PCACG were proposed.