PurposeTo 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.MethodsForty-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.ResultsAfter 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.ConclusionsCompared 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.

Purpose: To investigate the relationship between the Disc Damage Likelihood Scale (DDLS), visual field and various optical coherence tomography (OCT) parameters for glaucoma diagnosis. Methods: The study comprised 149 eyes from 149 patients. The patients were categorized as normal, glaucoma suspect or with glaucoma. They were clinically examined and graded according to the DDLS system. OCT was performed to acquire both a retinal nerve fibre layer analysis and an optic nerve head analysis. The relationships between DDLS score, visual field and OCT parameters were analysed using multiple correlation analysis. Results: The normal, glaucoma suspect and glaucoma groups had average DDLS scores of 1.58 ± 1.40, 2.55 ± 1.93 and 5.33 ± 1.39, respectively. Evaluating the area under the receiver operator characteristic curve, the DDLS had the best predictive power (0.917), followed by corrected pattern standard deviation. Conclusion: The DDLS is a useful parameter in the diagnosis of glaucoma and it showed a close correlation with visual field, cup/disc ratio and OCT parameters.

Although most patients acknowledged that they received sufficient information to give consent, few could objectively recall the information given to them. This study thus raises some doubts on the validity and quality of written informed consent, and highlights the importance of giving clear information to patients undergoing glaucoma surgery.

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