Effects of laser peripheral iridotomy on corneal endothelial cell density and cell morphology in primary angle closure suspect subjects

Jamali, Hossein; Jahanian, Sara; Gharebaghi, Reza

doi:10.4103/2008-322x.188395

Cited by 15 publications

(11 citation statements)

References 19 publications

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“…[17,18] Instead of CCT, multiple studies have shown irreversible corneal endothelial damage caused by surgeries, laser procedures, and even topical medications. [16][17][18][19][20][21][22] In relevance to the eld of glaucoma, many researchers have studied associations between the corneal endothelial loss with glaucoma subtypes. Shiota et al investigated corneal endothelial status across subtypes of angle closure glaucoma.…”

Section: Discussionmentioning

confidence: 99%

Rate of Central Corneal Thickness Changes in Primary Angle Closure Eyes: Long-term Follow-up Results

Park

Choi

Lee

et al. 2020

Preprint

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Background Central corneal thickness (CCT) and its association with intraocular pressure, which is a pivotal parameter in glaucoma management, has previously been reported. In this study, we intended to investigate the long-term change of CCT in terms of rate in eyes with primary angle closure (PAC). Additionally, we aimed to analyze events that could affect CCT.Methods In this retrospective study, 27 patients with PAC who had a follow-up period of more than five years were evaluated. The rate of CCT changes from baseline was evaluated from the serial CCT measurements over the average follow-up period. The pattern of CCT change rate according to modes of treatment and history of angle closure attack was analyzed using the repeated linear mixed model analysis.Results A total of 52 eyes were enrolled. The CCT reduction rate of the entire study population was − 0.72 ± 0.22 µm/yr (P = 0.001) with statistical significance. The CCT thinning rate of the laser peripheral iridotomy (PI) group was − 0.53 ± 0.25 µm/yr (P = 0.034), that of the surgical trabeculectomy group was − 1.32 ± 0.43 µm/yr (P = 0.002), and it was not statistically significant (P = 0.112). The rate of CCT thinning in patients with a history of acute angle closure attack was − 0.81 ± 0.31 µm/yr (P = 0.009) and that in patients without an attack was − 0.63 ± 0.30 µm/yr (P = 0.001), and it was not statistically significant (P = 0.680). Baseline CCT appeared to be the only significant factor affecting the rate of CCT changes (P < 0.001).Conclusions We found a significant reduction in CCT over a long-time observation period in PAC eyes. We also found that the rates of CCT reduction were not affected by different treatment modalities or acute angle closure attack. The analysis of long-term CCT changes in conjunction with baseline CCT would also be helpful in the clinical evaluation of the PAC patients.

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Section: Discussionmentioning

confidence: 99%

Rate of Central Corneal Thickness Changes in Primary Angle Closure Eyes: Long-term Follow-up Results

Park

Choi

Lee

et al. 2020

Preprint

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“…[14] However, there are studies available which have shown no significant decline corneal endothelial cell density and central corneal thickness following prophylactic laser iridotomy in primary angle closure suspect over 5 weeks to 1 year. [151617]…”

Section: Discussionmentioning

confidence: 99%

A study of endothelial cell count pre- and post-neodymium-doped yttrium aluminum garnet laser iridotomy in subacute angle closure using specular microscope

Bansal

Aggarwal

Kaur

et al. 2019

Taiwan J Ophthalmol

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AIM: The aim of this study was to study the effect of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser iridotomy on corneal endothelial cell count in patients with subacute angle closure using specular microscope. MATERIALS AND METHODS: In this prospective study, 50 cases of narrow-angle Grade 1 and Grade 2 (Shaffer gonioscopic grading) visiting the Regional Institute of Ophthalmology, Government Medical College, Amritsar underwent Nd:YAG laser peripheral iridotomy. After obtaining informed written consent, specular microscopy was performed before and after iridotomy at 1 week, 1 month, 3 rd month, and at 6 th -month follow-up visits. Central, nasal, and temporal endothelial cell counts were evaluated through noncontact specular microscopy. RESULTS: The mean participant age was 51.52 ± 7.9 years, and majority of the participants were females (76%). The mean IOP before the laser was 19.25 ± 1.914 mmHg and it varied from 18.50 ± 1.647 to 18.25 ± 1.699 mmHg (day 1, p = 0.06 and at 6 months, p = 0.04) following laser procedure. The mean corneal endothelial cell count at superotemporal site before laser peripheral iridotomy was 2844 ± 260, and this value decreased to 2807 ± 263, 2699 ± 267, 2656 ± 270, and 2591 ± 275 cells/mm 2 at postiridotomy, 1, 3, and 6 months’ follow-up visits, respectively; these differences were statistically significant ( p < 0.05). The mean total energy required to produce iridotomy was 14.88 ± 6.71 mJ, ranging from 5 to 37 mJ. The linear regression analysis indicated no statistical correlation between change in endothelial cell count at the treated site and total mean energy used. No significant difference was found between preiridotomy and postiridotomy corneal thickness at any site. CONCLUSION: This study demonstrated a significant endothelial cell loss at the treated site in 6 months’ follow-up and suggested that Nd:YAG laser iridotomy may pose hazard to the corneal endothelium, although corneal decompensation at the treated site or as a whole was not seen.

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“…There is controversy regarding the safety of this procedure to the corneal endothelium. [ 22 23 24 ] In a meta-analysis, Wang et al . [ 25 ] reported that though the LPI has been demonstrated to be a relatively safe procedure, there is still a potential long-term risk of corneal decompensation for which a corneal transplantation may be indicated eventually.…”

Section: Nd:yag Laser Peripheral Iridotomy (Lpi)mentioning

confidence: 99%

Lasers in glaucoma

Kumar

Mansoori

Warjri

et al. 2018

Indian J Ophthalmol

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Effects of laser peripheral iridotomy on corneal endothelial cell density and cell morphology in primary angle closure suspect subjects

Cited by 15 publications

References 19 publications

Rate of Central Corneal Thickness Changes in Primary Angle Closure Eyes: Long-term Follow-up Results

Rate of Central Corneal Thickness Changes in Primary Angle Closure Eyes: Long-term Follow-up Results

A study of endothelial cell count pre- and post-neodymium-doped yttrium aluminum garnet laser iridotomy in subacute angle closure using specular microscope

Lasers in glaucoma

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