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Aims: To evaluate temporal change in anterior chamber angle anatomy following argon laser peripheral iridoplasty (ALPI) in eyes with occludable angles postlaser peripheral iridotomy (LPI) compared with control eyes. Additionally, the effect on diurnal intraocular pressure (DIOP) fluctuation (maximum-minimum IOP) was investigated.

Methods: Twenty-two patients with bilateral primary angle closure/suspects with gonioscopically occludable anterior chamber angles following LPI were randomised to receive ALPI (n=11) or no further treatment (n=11). Angle opening distance (AOD), trabecular-iris angle, angle recess area and trabecular-iris space area were measured over eight sections with swept-source anterior segment optical coherence tomography and DIOP was measured pre-LPI and repeated at 3 months after ALPI (hourly measures).

Results: All angle parameters increased following ALPI. This change was maintained for 3 months in seven of the eight sections (eg, inferotemporal AOD500 increased by 0.063 mm, p=0.004 at 1 day; 0.051 mm, p=0.029 at 1 week; 0.059 mm, p=0.006 at 6 weeks and 0.056 mm, p=0.011 at 3 months). The only exception was in the inferior sector (eg, AOD500 increased by 0.041 mm, p=0.025 at 1 day and by 0.029 mm, p=0.054 at 3 months). DIOP at 3 months was significantly reduced (5.04 mm Hg; ±1.61 mm Hg) compared with controls (6.61 mm Hg; ±1.63 mm Hg). Maximum IOP was significantly greater in the non-ALPI group (1.87 mm Hg, p=0.026).

Conclusions: ALPI widened all angle sections in eyes that remained occludable post-LPI. Changes were maintained for 3 months. ALPI decreased DIOP fluctuation in the treated eyes by lowering the maximum IOP value.

Competing Interests: Competing interests: None declared.

(Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.)

Titel:	Temporal ocular coherence tomography-measured changes in anterior chamber angle and diurnal intraocular pressure after laser iridoplasty: IMPACT study.
Autor/in / Beteiligte Person:	Bourne, RRA ; Zhekov, I ; Pardhan, S
Zeitschrift:	The British journal of ophthalmology, Jg. 101 (2017-07-01), Heft 7, S. 886-891
Veröffentlichung:	Jan. 1992- : London : BMJ Pub. Group ; <i>Original Publication</i>: 1917-Dec. 1991: London : British Medical Association, 2017
Medientyp:	academicJournal
ISSN:	1468-2079 (electronic)
DOI:	10.1136/bjophthalmol-2016-308720
Schlagwort:	Anterior Chamber physiopathology Anterior Chamber surgery Double-Blind Method Female Follow-Up Studies Glaucoma, Open-Angle diagnosis Glaucoma, Open-Angle physiopathology Gonioscopy Humans Lasers, Solid-State therapeutic use Male Middle Aged Postoperative Period Prospective Studies Time Factors Anterior Chamber diagnostic imaging Circadian Rhythm physiology Glaucoma, Open-Angle surgery Intraocular Pressure physiology Iridectomy methods Laser Therapy methods Tomography, Optical Coherence methods
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article; Randomized Controlled Trial Language: English [Br J Ophthalmol] 2017 Jul; Vol. 101 (7), pp. 886-891. <i>Date of Electronic Publication: </i>2016 Dec 07. MeSH Terms: Anterior Chamber / diagnostic imaging ; Circadian Rhythm / physiology ; Glaucoma, Open-Angle / surgery ; Intraocular Pressure / physiology ; Iridectomy / methods ; Laser Therapy / methods ; Tomography, Optical Coherence / *methods ; Anterior Chamber / physiopathology ; Anterior Chamber / surgery ; Double-Blind Method ; Female ; Follow-Up Studies ; Glaucoma, Open-Angle / diagnosis ; Glaucoma, Open-Angle / physiopathology ; Gonioscopy ; Humans ; Lasers, Solid-State / therapeutic use ; Male ; Middle Aged ; Postoperative Period ; Prospective Studies ; Time Factors References: J Glaucoma. 2001 Apr;10(2):89-94. (PMID: 11316102) ; Korean J Ophthalmol. 2011 Aug;25(4):252-6. (PMID: 21860572) ; Int Ophthalmol. 1995;19(2):67-70. (PMID: 8586498) ; Br J Ophthalmol. 2016 Apr;100(4):542-8. (PMID: 26294102) ; Ophthalmology. 2005 Jun;112(6):980-4. (PMID: 15936438) ; Ophthalmology. 2002 Sep;109(9):1591-6. (PMID: 12208703) ; Surv Ophthalmol. 2007 May-Jun;52(3):279-88. (PMID: 17472803) ; Eye (Lond). 2006 Mar;20(3):309-14. (PMID: 16021197) ; Br J Ophthalmol. 2012 Jul;96(7):967-70. (PMID: 22510582) ; Invest Ophthalmol Vis Sci. 2015 May;56(5):2943-9. (PMID: 26024080) ; Am J Ophthalmol. 2010 Jul;150(1):68-73. (PMID: 20472226) ; Ophthalmology. 2016 Mar;123(3):514-21. (PMID: 26707418) ; Clin Ophthalmol. 2013;7:63-9. (PMID: 23326185) Contributed Indexing: Keywords: Anterior chamber; Clinical Trial; Glaucoma; Imaging; Treatment Lasers Entry Date(s): Date Created: 20161209 Date Completed: 20170721 Latest Revision: 20190221 Update Code: 20240513 PubMed Central ID: PMC5530805

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Temporal ocular coherence tomography-measured changes in anterior chamber angle and diurnal intraocular pressure after laser iridoplasty: IMPACT study.