Anterior Chamber Angle and Intraocular Pressure Control After Phacoemulsification in Primary Angle Closure With Different Mechanisms.

Publisher: Wolters Kluwer Health, Inc Country of Publication: United States NLM ID: 9300903 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1536-481X (Electronic) Linking ISSN: 10570829 NLM ISO Abbreviation: J Glaucoma Subsets: MEDLINE

Publication: <2015- > : Philadelphia, PA : Wolters Kluwer Health, Inc.
Original Publication: New York, N.Y. : Raven Press, c1992-

Intraocular Pressure*/physiology ; Phacoemulsification* ; Glaucoma, Angle-Closure*/physiopathology ; Glaucoma, Angle-Closure*/surgery ; Tomography, Optical Coherence* ; Anterior Chamber*/diagnostic imaging ; Anterior Chamber*/pathology ; Tonometry, Ocular* ; Lens Implantation, Intraocular*; Humans ; Retrospective Studies ; Male ; Female ; Aged ; Middle Aged ; Gonioscopy ; Aged, 80 and over

Prcis: Different mechanisms of angle closure represented distinct aspects of intraocular pressure (IOP) control after phacoemulsification. Classification of angle closure mechanisms is necessary for postoperative IOP management and glaucoma progression in primary angle closure eyes.
Purpose: To investigate the relationship between the anterior chamber angle (ACA) characteristics, measured by swept-source anterior segment optical coherence tomography (SS AS-OCT), and intraocular pressure (IOP) control after phacoemulsification in eyes with primary angle closure disease (PACD) with different angle closure mechanisms.
Methods: PACD eyes were classified into 3 groups according to angle closure mechanisms using preoperative SS AS-OCT images; pupillary block (PB), plateau iris configuration (PIC), exaggerated lens vault (ELV). This retrospective, clinical cohort study included eighty-five eyes of 85 PACD patients: 34 with PB, 23 with PIC, and 28 with ELV. ACA parameters were measured preoperatively and 1 month postoperatively using SS AS-OCT. IOP measurements were performed preoperatively and during 6 months postoperatively. Postoperative IOP reduction and fluctuation were calculated, and their correlations with SS AS-OCT parameters were analyzed.
Results: PIC group showed the lowest postoperative IOP reduction compared with the other groups ( P =0.023). Preoperative ACA measurements were significantly associated with postoperative IOP reduction in ELV and PB groups, while postoperative measurements were in PIC group. Preoperative and postoperative change of iridotrabecular contact (ITC) index and area were correlated with postoperative IOP reduction in PB and ELV groups but not in PIC group. Postoperative ITC index ( P =0.031) and area ( P =0.003) showed significant correlations with postoperative IOP fluctuation only in PIC group.
Conclusions: SS AS-OCT parameters including ITC index and area showed different associations with postoperative IOP control, which should be considered in determination of lens extraction and treatment of PACD eyes.
Competing Interests: Disclosure: The authors declare no conflict of interest.
(Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

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Date Created: 20240627 Date Completed: 20240919 Latest Revision: 20240919

20240923

10.1097/IJG.0000000000002454

38934849