Long-term Outcome of Anterior Chamber Parameters after Laser Iridotomy and Iridoplasty in Primary Angle Closure Glaucoma

Se Ik Park, Woo-Hyuk Lee, T. Kang, Ji Hye Kim, Yongseop Han, Hyun-kyung Cho
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Abstract

Purpose: To investigate the long-term outcomes of anterior chamber angle parameters in patients with primary angle closure glaucoma (PACG) after peripheral laser iridotomy (LI) combined with iridoplasty (PI) using a dual Scheimpflug analyzer.Methods: This retrospective study included 32 eyes in 32 patients diagnosed with PACG who underwent LI plus PI. Patients with an acute angle closure crisis were excluded. Dual Scheimpflug analyzer images were acquired before and 1 week after LI plus PI, and yearly afterwards. Anterior chamber depth (ACD) and volume (ACV), mean anterior chamber angle (ACA), and intraocular pressure (IOP) were also measured.Results: The mean follow-up was 32.28 ± 13.34 months. Baseline demographics were age 63 ± 7.9 years, 62.5% female, IOP 15.48 ± 4.79 mmHg, ACD 2.09 ± 0.19 mm, and visual field mean deviation -7.97 ± 8.49 dB. ACD increased from baseline to 2.15 ± 0.32 mm, but it was not significant (p = 0.136). ACV increased significantly from 78.32 ± 11.49 mm at baseline to 83.04 ± 11.16 mm at the last visit after LI (p = 0.011). The mean ACA increased significantly from 26.86 ± 2.53° at baseline to 28.82 ± 4.64° at the last visit (p = 0.022). IOP decreased significantly from baseline to 13.06 ± 2.21 mmHg at the last visit (p = 0.001).Conclusions: The ACA parameters improved after LI combined with PI in patients with PACG and remained so on long-term follow-up. IOP was also significantly reduced for more than 2.5 years after LI plus PI.
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原发性闭角型青光眼激光虹膜切开术及虹膜成形术后前房参数的远期疗效
目的:使用双Scheimpflug分析仪研究原发性闭角型青光眼(PACG)患者外周激光虹膜切开术(LI)联合虹膜成形术(PI)后前房角度参数的长期结果。方法:对32例PACG患者的32只眼进行了回顾性研究。有急性闭角危象的患者被排除在外。双Scheimpflug分析仪图像在LI加PI之前和之后1周采集,之后每年采集一次。还测量了前房深度(ACD)和容积(ACV)、平均前房角度(ACA)和眼压(IOP)。结果:平均随访32.28±13.34个月。基线人口统计数据为年龄63±7.9岁,女性62.5%,IOP 15.48±4.79 mmHg,ACD 2.09±0.19 mm,视野平均偏差-7.97±8.49 dB。ACD从基线增加到2.15±0.32mm,但并不显著(p=0.0136)。LI后ACV从基线时的78.32±11.49mm显著增加到最后一次访视时的83.04±11.16mm(p=0.011)。平均ACA从基线时26.86±2.53°显著增加到上次访视时28.82±4.64°(p=0.022)。IOP从基线时显著降低到最后一次访视时13.06±2.21mmHg(p=0.001)。结论:ACA在PACG患者中,LI联合PI后参数有所改善,并在长期随访中保持不变。在LI加PI后的2.5年内,IOP也显著降低。
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