Functional evaluation of an iridotomy in primary angle closure eyes

Sihota, Ramanjit; Rishi, Karandeep; Srinivasan, Geetha; Gupta, Viney; Dada, Tanuj; Singh, Kulwant

doi:10.1007/s00417-016-3298-x

Cited by 15 publications

(11 citation statements)

References 43 publications

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“…15 Eyes with thicker iris, higher iris insertion and thicker lens will still have narrow angle after laser Iridotomy. 16 Greatest effect of Laser Peripheral Iridotomy is seen in eyes with greatest baseline pupil block. 17 Laser trabeculoplasty has role in narrow angle as well once angle is opened by laser iridotomy or Iridoplasty.…”

Section: Discussionmentioning

confidence: 99%

Role of Anterior Segment OCT in the Management of Primary Narrow Angle Disease

Muid¹,

Farooq²

2020

pak J Ophthalmol

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Purpose: To highlight the role of anterior segment OCT, in complementing gonioscopic findings in the management of angle closure glaucoma. Study Design: Descriptive observational case series. Study Place and Duration: Study was conducted at Eye department of Shifa International Hospital, from January 2019 to March 2019. Methods: After taking informed consent from the patients, the study was conducted at Shifa International Hospital Islamabad. Patients were selected by convenient sampling technique. Patients were diagnosed on the basis of history and clinical examination. Patients with angle closure on Gonioscopy were included in this series. Detailed ocular examination including visual acuity for distance and near, tonometry, Gonioscopy and anterior segment OCT were performed. Data was collected and presented as case series. Results: The median age 57 years with 50% more than 60 years and 50% less than 60 years of age. Presenting IOP was less than 21 mmHg in 50% and higher in remaining 50%. On examination 37.5% were categorized as PACS, 12.5% having PAC and 50% as PACG. After definitive treatment 12.5% still needed medical treatment to prevent progression in PACG and none in PACS and PAC. Conclusion: In narrow angle disease, treatment is designed not only to control intraocular pressure (IOP) but also to keep angle open as much as possible. Appositional closure or peripheral anterior synechiae (PAS) can damage the trabecluar meshwork. Iridoplasty, peripheral Iridotomy (PI) and early lens extraction can defer the need for filtration procedure if done well in time. Key Words: OCT anterior segment, Narrow angle, Optic nerve head.

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Section: Discussionmentioning

confidence: 99%

Role of Anterior Segment OCT in the Management of Primary Narrow Angle Disease

Muid¹,

Farooq²

2020

pak J Ophthalmol

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“…[29] Interestingly, it has been reported that the extent of PAS did not correlate with the rise in IOP seen on provocative tests such as the dark room test, pharmacologic mydriasis, and the Valsalva test in patients with PAC. [18] Parameters identifying eyes that continue to develop angle closure after an iridotomy would lead to better management of PAC. Although LPI is claimed to prevent PACS progression to PAC or PACG, it is not guaranteed, as some patients progress despite successful LPI.…”

Section: Discussionmentioning

confidence: 99%

“…An increase in IOP of ≥ 6 mmHg from baseline was considered a positive result on both provocative tests. [18] Secondary outcomes were refraction ocular biometric parameters obtained using Lenstar LS 900 (Haag-Streit AG, Koeniz, Switzerland) and Pentacam HR (Oculus, Wetzlar, Germany) optical biometers. The following parameters were collected from the Lenstar biometer: mean keratometry (Km), keratometric astigmatism (Ka), central corneal thickness (CCT), axial length (AL), and lens thickness (LT).…”

Section: Measurementsmentioning

confidence: 99%

Water-drinking Test and Pharmacologic Mydriasis as Provocative Tests in Primary Angle Closure Suspects

Razeghinejad¹,

Nowroozzadeh²

2019

JOVR

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PurposeTo compare the water-drinking test (WDT) and pharmacologic mydriasis as provocative tests in patients with primary angle closure suspect (PACS).MethodsThis observational non-randomized comparative study evaluated changes in intraocular pressure (IOP) in 21 patients with PACS who underwent pharmacologic mydriasis and compared it with IOP changes in 26 patients given the WDT. Ocular biometric and anterior chamber parameters were also assessed. Tests were repeated on the same patient two weeks after performing laser peripheral iridotomy (LPI).ResultsThe mean age ± standard deviation was 60 ± 7 and 57 ± 9 years in the mydriasis and WDT groups, respectively (P = 0.201). Before LPI, both provocative tests were associated with a significant increase in IOP (mydriasis: 15.1 ± 3.1 to 16.6 ± 3.5 mmHg, P = 0.025; WDT: 16.2 ± 2.8 to 18.5 ± 3.3 mmHg, P < 0.001). However, the IOP changes were not statistically different between groups (P = 0.102). After LPI, only the WDT group showed a continued significant IOP elevation after the test (mydriasis: 16.4 ± 3.3 to 16.7 ± 3.5 mmHg, P = 0.569; WDT: 14.9 ± 3.0 to 17.8 ± 4.1 mmHg, P < 0.001). The post-test IOP change was significantly greater in the WDT than in the mydriasis group (3.0 versus 0.3 mmHg, respectively; P = 0.002). Step-wise multiple regression analysis verified the type of provocative test as the only independent factor affecting the post-test IOP change after LPI (regression coefficient: 2.664; P = 0.002).ConclusionPharmacologic mydriasis and the WDT had similar IOP elevation before LPI, but after LPI, IOP elevation was much greater in the WDT group.

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“…Eyes with a very narrow angle or a thick lens may continue to have angle closure due to other pathomechanisms for angle closure. [ 13 ] Iridotomy is done for therapeutic purposes to relieve an acute angle closure attack and to relieve the raised IOP in eyes with iris bombe due to secondary angle closure. …”

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

confidence: 99%

“…Eyes with a very narrow angle or a thick lens may continue to have angle closure due to other pathomechanisms for angle closure. [ 13 ]…”

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

confidence: 99%