Laser Peripheral Iridotomy with Iridoplasty in Primary Angle Closure Suspect: Anterior Chamber Analysis by Pentacam

Abstract

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.

To Study the Efficacy of Laser Peripheral Iridoplasty in the Treatment of Eyes With Primary Angle Closure and Plateau Iris Syndrome, Unresponsive to Laser Peripheral Iridotomy, Using Anterior-Segment OCT as a Tool

“…In a study conducted by Lee et al, 25 the authors compared conventional LPI alone and LPI combined with LPIp in eyes diagnosed as PACS by the assessment of anterior-chamber dimensional changes using a Pentacam. In this study, conventional LPI was performed on 1 randomly selected eye by a single glaucoma specialist using an argon laser, and a week later, the complementary eye was treated with LPI combined with LPIp.…”

Comparison of circumferential peripheral angle closure using iridotrabecular contact index after laser iridotomy versus combined laser iridotomy and iridoplasty

“…In a study that included PACS for the comparison of LI and LI combined with PI assessed by Pentacam, postprocedure IOP did not significantly differ between the two groups during 3 months after treatment when the baseline IOP values did not significantly differ either between eye treated by conventional LI and LI plus iridoplasty (Lee et al. ). In a randomized pilot study that included synechial PAC or PACG, IOP was reduced significantly after LI or LI plus PI.…”

“…Lee et al. () have reported that LI plus PI can improve the mid‐to‐peripheral ACD increase assessed by Pentacam in subjects with PACS compared to conventional LI. Previous studies including a population study have also revealed that 19.4% to 42.9% of the anterior chamber angles of angle closure eyes after undergoing LI have remained closed (Alsagoff et al.…”

Primary angle‐closure glaucoma: an update

“…; Lee et al. ). The current consensus view is that APLI alone is of limited use outside of the acute setting, where it may be used to break the attacks of acute angle closure (Ng et al.…”

“…, ; Lee et al. ). In one study, 87% of plateau iris eyes treated with ALPI had open angles at the end of long‐term follow‐up (mean 79 months) after a single treatment, with no need for future filtration surgery (Ritch et al.…”