J Korean Ophthalmol Soc.  2023 May;64(5):423-430. 10.3341/jkos.2023.64.5.423.

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

• Park SI
• Lee WH
• Kang TS
• Kim JH
• Han YS
• Cho HK

• KMID: 2542180
• DOI: http://doi.org/10.3341/jkos.2023.64.5.423

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.

Keyword

Anterior chamber angle, Dual scheimpflug analyzer, Laser iridoplasty, Laser iridotomy, Primary angle-closure