TITLE:
Research Progress on Preventive Laser Peripheral Iridotomy in Patients with Primary Angle-Closure Suspect
AUTHORS:
Yuting Du, Di Zhang
KEYWORDS:
Primary Angle Closure Suspect, Laser Peripheral Iridotomy, End Event Conversion Rate, Preventive Efficiency, Cataract Surgery
JOURNAL NAME:
Journal of Biosciences and Medicines,
Vol.14 No.4,
April
20,
2026
ABSTRACT: Glaucoma is one of the most serious ophthalmological diseases threatening vision globally. Among them, Primary Angle Closure Glaucoma (PACG) is the most common type in China. Primary Angle Closure Suspect (PACS) represents the earliest morphological stage of pupillary block, serving as an early phase in the chain of PACG onset. Early screening for this population is a critical node to prevent further progression to PACG and thereby avoid irreversible visual field damage. Laser peripheral iridotomy (LPI) is widely regarded as the most common treatment modality for PACS patients. Performing LPI can prevent further closure of the anterior chamber angle and fundamentally resolve pupillary blockage. However, recent prospective clinical studies have shown that while LPI significantly reduces the conversion rate from PAC/PACG, due to the extremely low endpoint event conversion rate inherent to the PACS population and its large base size, the preventive efficacy of LPI is very low. Therefore, it is not recommended to widely apply prophylactic LPI to this group. Although LPI is considered a safe and effective non-invasive procedure, it does not represent complete harmlessness; the complications pose significant risks to patients. Therefore, careful differential diagnosis of indications and comprehensive judgment regarding whether to perform prophylactic LPI should be made. It is advocated to implement risk stratification for PACS patients and consider using prophylactic LPI for those with high-risk factors. Currently, research on high-risk factors is still ongoing. In the context of actively promoting cataract surgery, early cataract extraction for PACS patients has become an undeniable new trend.