Laser peripheral iridotomy with iridoplasty in primary angle closure suspect: anterior chamber analysis by pentacam
Jong Rak Lee, Jin Young Choi, Yeon-Deok Kim, Jaewan Choi, Jong Rak Lee, Jin Young Choi, Yeon-Deok Kim, Jaewan Choi
Abstract
Purpose: To compare conventional laser peripheral iridotomy (LPI) and LPI combined with laser peripheral iridoplasty in eyes with primary angle closure suspect (PACS) by assessment of anterior chamber dimensional changes using a Pentacam.
Methods: Forty-eight eyes of 24 subjects with bilateral PACS were recruited consecutively. Each eye was randomly allocated to treatment with conventional LPI, argon LPI only, or LPI plus iridoplasty, which consisted of simultaneous argon LPI and peripheral iridoplasty. Anterior chamber measurements were performed on each eye using a Pentacam, both before and after treatment. Mean anterior chamber depth (ACD), anterior chamber volume (ACV), and anterior chamber angle were measured, and topographic ACD analysis was performed. Results were compared between the two treatment groups.
Results: After treatment with either conventional LPI or LPI plus iridoplasty, the mean ACD and ACV increased significantly. Topographic ACD analysis revealed that the mid-to-peripheral ACD increase was significantly greater in the LPI plus iridoplasty group than in eyes treated with conventional LPI. Intraocular pressure changes and post-LPI complications did not differ between the groups.
Conclusions: Compared with conventional LPI, our study showed that LPI plus iridoplasty improved the mid-to-peripheral ACD increase. This procedure may have a role as an adjunct for reducing angle closure by simultaneously eliminating pupillary and non-pupillary block components.
Keywords: Laser peripheral iridoplasty; Laser peripheral iridotomy; Pentacam; Primary angle closure suspect.
Conflict of interest statement
No potential conflict of interest relevant to this article was reported.
Figures
References
- European Glaucoma Society. Terminology and guidelines for glaucoma. 3rd ed. Savona: Dogma; 2008.
- Shen SY, Wong TY, Foster PJ, et al. The prevalence and types of glaucoma in malay people: the Singapore Malay Eye Study. Invest Ophthalmol Vis Sci. 2008;49:3846–3851.
- Casson RJ, Newland HS, Muecke J, et al. Prevalence of glaucoma in rural Myanmar: the Meiktila Eye Study. Br J Ophthalmol. 2007;91:710–714.
- Thomas R, George R, Parikh R, et al. Five year risk of progression of primary angle closure suspects to primary angle closure: a population based study. Br J Ophthalmol. 2003;87:450–454.
- Thomas R, Parikh R, Muliyil J, Kumar RS. Five-year risk of progression of primary angle closure to primary angle closure glaucoma: a population-based study. Acta Ophthalmol Scand. 2003;81:480–485.
- Ang MH, Baskaran M, Kumar RS, et al. National survey of ophthalmologists in Singapore for the assessment and management of asymptomatic angle closure. J Glaucoma. 2008;17:1–4.
- Pandav SS, Kaushik S, Jain R, et al. Laser peripheral iridotomy across the spectrum of primary angle closure. Can J Ophthalmol. 2007;42:233–237.
- He M, Friedman DS, Ge J, et al. Laser peripheral iridotomy in primary angle-closure suspects: biometric and gonioscopic outcomes: the Liwan Eye Study. Ophthalmology. 2007;114:494–500.
- Kumar RS, Baskaran M, Chew PT, et al. Prevalence of plateau iris in primary angle closure suspects an ultrasound biomicroscopy study. Ophthalmology. 2008;115:430–434.
- Kumar RS, Tantisevi V, Wong MH, et al. Plateau iris in Asian subjects with primary angle closure glaucoma. Arch Ophthalmol. 2009;127:1269–1272.
- Pavlin CJ, Ritch R, Foster FS. Ultrasound biomicroscopy in plateau iris syndrome. Am J Ophthalmol. 1992;113:390–395.
- Ritch R. Plateau iris is caused by abnormally positioned ciliary processes. J Glaucoma. 1992;1:23–26.
- Ritch R, Tham CC, Lam DS. Argon laser peripheral iridoplasty (ALPI): an update. Surv Ophthalmol. 2007;52:279–288.
- Ritch R, Tham CC, Lam DS. Long-term success of argon laser peripheral iridoplasty in the management of plateau iris syndrome. Ophthalmology. 2004;111:104–108.
- Sassani JW, Ritch R, McCormick S, et al. Histopathology of argon laser peripheral iridoplasty. Ophthalmic Surg. 1993;24:740–745.
- Van Herick W, Shaffer RN, Schwartz A. Estimation of width of angle of anterior chamber. Incidence and significance of the narrow angle. Am J Ophthalmol. 1969;68:626–629.
- Boker T, Sheqem J, Rauwolf M, Wegener A. Anterior chamber angle biometry: a comparison of Scheimpflug photography and ultrasound biomicroscopy. Ophthalmic Res. 1995;27(Suppl 1):104–109.
- Pavlin CJ, Harasiewicz K, Foster FS. Ultrasound biomicroscopy of anterior segment structures in normal and glaucomatous eyes. Am J Ophthalmol. 1992;113:381–389.
- Kurita N, Mayama C, Tomidokoro A, et al. Potential of the pentacam in screening for primary angle closure and primary angle closure suspect. J Glaucoma. 2009;18:506–512.
- Rabsilber TM, Khoramnia R, Auffarth GU. Anterior chamber measurements using Pentacam rotating Scheimpflug camera. J Cataract Refract Surg. 2006;32:456–459.
Source: PubMed