Morphometric features that characterize increased risk of acute angle-closure glaucoma in patients with high axial hyperopia planning refractive surgery

Purpose. To study of quantitative and qualitative morphometric characteristics of the anterior chamber (AC) depth, lens thickness (LT), corneal-iris angle in young patients with high axial hyperopia planning refractive surgery. Material and methods. The main group – 35 patients (70 eyes) with high axial hyperopia. Inclusion criteria: absence of ophthalmic and systemic somatic pathology. The best corrected visual acuity (BCVA) is from 0.7 to 1.0. The comparison group included 35 patients (70 eyes) with primary closure of the anterior chamber angle (ACA) in combination with high hyperopia. Inclusion criteria: the presence of functional block of the ACA in at least 2 quadrants, the absence of signs of glaucomatous optic neuropathy. BCVA – from 0.6 to 0.9. All patients underwent gonioscopy of the ACA in 4 quadrants, optical coherence tomography, assessment of morphometric parameters of the anterior segment of the eyes. Results. The analysis of morphometric parameters revealed statistically significant differences in patients of the main group relative to the comparison group: in the AC depth in the central zone – 2.8 ± 0.3 vs. 2.4 ± 0.25 mm; LT – 4.0 ± 0.35 vs. 4.5 ± 0.3 mm; ACA width – 19.6 ± 4.4° vs. 13.1±5.1°; AC depth in the periphery – 1.0 ± 0.21 vs. 0.5 ± 0.37 mm, respectively. Next, we determined whether anyone from the main group had ACA values similar to the average values of this indicator of the comparison group (13.1 ± 5.1°): in 6 eyes of the main group (3 men aged 40 to 45 years) the values of the ACA turned out to be minimal, not significantly differing from the comparison group. In addition, in 7 eyes of 6 patients of the main group, the index of the AC depth in the periphery was less than 0.5 mm with normal values of the AC depth in the central zone, which was comparable with similar values in the comparison group. Conclusion. Among the examined patients with hyperopia at the age of 39 to 45 years, with axial length values from 19 to 22 mm, an increased risk of developing an acute angle-closure glaucoma occurred in 9 patients (26 %). Keywords: hyperopia; refractive surgery; acute angle-closure glaucoma