Laser peripheral iridectomy use in the unoperated eyes of hospitalised patients with primary angle-closure glaucoma in a national multicentre study in China

Objective To investigate the use of laser peripheral iridectomy (LPI) in the unoperated eyes of hospitalised patients with primary angle-closure glaucoma (PACG). Methods This was a national multi-centre retrospective study, and the sample was selected via multi-stage stratified random sampling from 26 hospitals. Data on LPI use were extracted from the electronic medical records (EMRs) of 5,404 PACG patients from 1 January 2011 to 31 December 2020. We used a generalised estimating equations (GEE) model to identify factors influencing LPI use. Results Among 3,525 unoperated eyes of hospitalised PACG patients, 35.3% of these eyes received LPI during hospitalisation, and the usage rate was 35.1% and 36.0% in provincial-level or above and in city-level hospitals, respectively. In multivariable models, an intraocular pressure (IOP) of > 21 mmHg (OR = 0.915; 95% CI [0.875, 0.956]), moderate visual impairment (OR = 0.898; 95% CI [0.849, 0.949]) and severe visual impairment or blindness (OR = 0.755; 95% CI [0.717, 0.794]) were associated with a lower LPI usage rate in unoperated eyes. By contrast, patients treated in the northern region had a higher LPI usage rate in unoperated eyes (OR = 1.343; 95% CI [1.295, 1.393]). Conclusions The usage rate of LPI in the unoperated eyes of PACG patients is relatively low in China, especially among patients in the southern region, with higher IOP and worse visual impairment.