The investigators wanted to reported the results of immediate anterior chamber paracentesis (ACP), compared to Mannitol infusion, in patients with acute primary angle-closure glaucoma (PACG). In this study, the investigators first divided patients into three sub-groups according to their initial intraocular pressure (IOP) for analyzing the differences of IOP control, severity of corneal edema, waiting time for laser peripheral iridotomy (LPI), and visual outcome between ACP and Mannitol infusion.

The investigators demonstrated that ACP could be first considered in patients with initial IOP between 45 to 60 mmHg because it provided better visual outcome than Mannitol infusion through the rapid stabilization of the anterior segment, which was achieved by rapid IOP control, better corneal edema regression, shortening waiting time for LPI. However, ACP should be considered in patients with the initial IOP of 60mmHg and higher only when Mannitol was contraindicated.

Inclusion Criteria:

• first attack of acute PACG;
• initial presenting IOP was higher than 45 mmHg;
• diagnosis confirmed by gonioscopic examination;
• patients within 48 hours of symptom onset.

Exclusion Criteria:

• been incompletely followed up within 2 weeks;
• been using anti-glaucomatous medication before ACP or Mannitol infusion;
• previous intraocular surgeries on the same eye;
• contraindication for Mannitol;
• history of other vision-threatening ocular diseases.

Glaucoma patients