Purpose To study changes in anterior segment morphology after laser peripheral iridotomy (LPI) in primary angle closure (PAC) using anterior segment optical coherence tomography (AS-OCT).Methods LPI was performed on 15 consecutive primary angle closure patients (15 eyes). AS-OCT was used to record the morphology of the anterior segment before and after LPI. The central anterior chamber (AC) depth, the diameter of the pupil, the lens thickness, and the AC volume were measured. The peripheral AC depth and the configuration of iris were also observed qualitatively. The intraocular pressure (IOP) was measured by Goldmann applanation tonometer. Results The mean central AC depth was 1.939±0.228 and 1.970±0.235 mm before and after LPI, respectively, increasing by 1.6%, P ¼ 0.001. In all eyes but two, the central AC depth increased. The AC volume changed significantly after LPI (73.86 ± 14.58 vs 84.14±17.45 ll, Po0.001) and it increased in all eyes. The iris flattened and the peripheral AC deepened after LPI in all 15 eyes. The mean IOP was 17.8±3.3 and 15.9±3.1 mmHg before and after LPI, respectively, P ¼ 0.042. The changes of pupil diameter and lens thickness were not statistically significant. Conclusions LPI leads not only to the increase of peripheral anterior chamber depth and anterior chamber volume but also to an increase of central anterior chamber depth in eyes with primary angle closure.

Purpose To report surgical outcomes of microcatheter-assisted trabeculotomy following failed angle surgeries, and compare those with no previous angle surgery, in primary congenital glaucoma (PCG). Methods The early postoperative (12 months) results of 42 eyes of 36 patients who underwent microcatheter-assisted trabeculotomy by single surgeon for PCG were retrospectively analyzed. Group 1, 20 eyes of 16 patients, had no previous angle surgery. Group 2, 22 eyes of 20 patients, had one or two previous failed angle surgeries. Success was defined as an intraocular pressure (IOP) o21 mm Hg with at least a 30% reduction from preoperative IOP with (qualified success) or without (complete success) the use of antiglaucoma medication. Results Mean IOP decreased from 31.5 ± 7.2 mm Hg on 3 (median, range: 1-5) medications in Group 1 and 34.6 ± 7.3 mm Hg on 3 (median, range: 1-4) medications in Group 2 preoperatively to 15.6 ± 3.1 mm Hg on 0 (median, range: 0-4) medications in Group 1 and 16.0 ± 4.6 mm Hg on 0 (median, range: 0-2) medications in Group 2 postoperatively at 12 months (both Po0.001), respectively. The mean percentage of IOP reduction from preoperative to last postoperative visit was 46.0 ± 20.1% in Group 1 and 45.5 ± 25.0% in Group 2, P = 0.947. Qualified and complete successes were comparable between Group 1 and Group 2 (qualified success: 90.0% vs 77.3%, P = 0.294; complete success: 78.9% vs 77.3%, P = 0.853). Complications were minimal. Conclusions Microcatheter-assisted trabeculotomy achieved significant pressurelowering effects with a reduction in medication use in PCG, and it represents a reasonable choice of initial and repeat surgical treatment for PCG.

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