Long-term effects of mild cataract extraction versus laser peripheral iridotomy on anterior chamber morphology in primary angle-closure suspect eyes.

Yan, C ; Yu, Y ; et al.

In: The British journal of ophthalmology, Jg. 108 (2024-05-21), Heft 6, S. 812-817

academicJournal

Aim: To compare lens extraction (LE) and laser peripheral iridotomy (LPI) on anterior segment morphology in primary angle-closure suspect (PACS) eyes.

Methods: This prospective clinical trial included 144 patients with PACS who underwent either LPI or LE. Ultrasound biomicroscopy (UBM) and gonioscopy were performed before and 1 month and 2 years after operation. Main outcomes included UBM parameters and the percentage of residual angle closure.

Results: At both 1 month and 2 years of follow-up, LE showed a better effect of relieving anterior chamber crowding and widening the drainage angle, as obtaining a larger anterior chamber depth (ACD), angle opening distance, trabecular iris angle (TIA), trabecular iris space area, trabecular ciliary process distance (TCPD) and a smaller iris curvature (I-Curv) and lens vault (LV) (p<0.001). In the LPI group, angle width increased (angle opening distance at 500 µm from the scleral spur, TIA and trabecular iris space area at 500 µm from the scleral spur) and I-Curv decreased (p<0.001) at 1 month postoperatively, with no significant changes in ACD, LV or TCPD. However, at 2 years after LPI, the angle narrowed with the increase in LV over time, and the proportion of residual angle closure also increased from 21.7% to 30.4% (p<0.001). In contrast, after LE, the widened angle width, flattened iris, deepened ACD, decreased LV and increased TCPD all showed good sustainability in the comparison between 1-month and 2-year follow-up. No residual angle closure was observed either at 1 month or 2 years after LE.

Conclusions: LE was prior to LPI in widening the drainage angle. After LPI, there was a narrowing of the angle and an increase in the proportion of residual angle closure over time. LE could achieve a wider angle with no residual angle closure, and the anterior segment parameters were sustainable.

Trial Registration Number: ChiCTR1800016511.

Competing Interests: Competing interests: None declared.

Titel:	Long-term effects of mild cataract extraction versus laser peripheral iridotomy on anterior chamber morphology in primary angle-closure suspect eyes.
Autor/in / Beteiligte Person:	Yan, C ; Yu, Y ; Wang, W ; Han, Y ; Yao, K
Zeitschrift:	The British journal of ophthalmology, Jg. 108 (2024-05-21), Heft 6, S. 812-817
Veröffentlichung:	Jan. 1992- : London : BMJ Pub. Group ; <i>Original Publication</i>: 1917-Dec. 1991: London : British Medical Association, 2024
Medientyp:	academicJournal
ISSN:	1468-2079 (electronic)
DOI:	10.1136/bjo-2022-322698
Schlagwort:	Humans Prospective Studies Male Female Aged Follow-Up Studies Middle Aged Cataract Extraction Treatment Outcome Glaucoma, Angle-Closure surgery Glaucoma, Angle-Closure physiopathology Glaucoma, Angle-Closure diagnosis Gonioscopy Anterior Chamber diagnostic imaging Anterior Chamber pathology Microscopy, Acoustic Iris surgery Iris diagnostic imaging Laser Therapy methods Intraocular Pressure physiology Iridectomy methods
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article; Comparative Study Language: English [Br J Ophthalmol] 2024 May 21; Vol. 108 (6), pp. 812-817. <i>Date of Electronic Publication: </i>2024 May 21. MeSH Terms: Glaucoma, Angle-Closure* / surgery ; Glaucoma, Angle-Closure* / physiopathology ; Glaucoma, Angle-Closure* / diagnosis ; Gonioscopy* ; Anterior Chamber* / diagnostic imaging ; Anterior Chamber* / pathology ; Microscopy, Acoustic* ; Iris* / surgery ; Iris* / diagnostic imaging ; Laser Therapy* / methods ; Intraocular Pressure* / physiology ; Iridectomy* / methods ; Humans ; Prospective Studies ; Male ; Female ; Aged ; Follow-Up Studies ; Middle Aged ; Cataract Extraction ; Treatment Outcome Contributed Indexing: Keywords: Anterior chamber; Glaucoma; Lens and zonules; Pathology Entry Date(s): Date Created: 20230206 Date Completed: 20240521 Latest Revision: 20240521 Update Code: 20240522

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