Anterior Chamber Angle and Intraocular Pressure Control After Phacoemulsification in Primary Angle Closure With Different Mechanisms.
Song Woo Keun, Sung Kyung Rim, Kim Ko Eun
AI Summary
This study found that different angle closure mechanisms impact post-phacoemulsification IOP control differently. Classifying angle closure mechanisms is crucial for personalized postoperative IOP management and treatment decisions.
Abstract
Précis: 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.
MeSH Terms
Shields Classification
Key Concepts5
In a retrospective, clinical cohort study of 85 PACD patients (34 with pupillary block, 23 with plateau iris configuration, and 28 with exaggerated lens vault), the plateau iris configuration group showed the lowest postoperative IOP reduction compared with the other groups (P = 0.023) after phacoemulsification.
In a retrospective, clinical cohort study of 85 PACD patients (34 with pupillary block, 23 with plateau iris configuration, and 28 with exaggerated lens vault), preoperative anterior chamber angle measurements were significantly associated with postoperative IOP reduction in the exaggerated lens vault and pupillary block groups after phacoemulsification.
In a retrospective, clinical cohort study of 85 PACD patients (34 with pupillary block, 23 with plateau iris configuration, and 28 with exaggerated lens vault), postoperative anterior chamber angle measurements were significantly associated with postoperative IOP reduction in the plateau iris configuration group after phacoemulsification.
In a retrospective, clinical cohort study of 85 PACD patients (34 with pupillary block, 23 with plateau iris configuration, and 28 with exaggerated lens vault), preoperative and postoperative change of iridotrabecular contact (ITC) index and area were correlated with postoperative IOP reduction in the pupillary block and exaggerated lens vault groups but not in the plateau iris configuration group after phacoemulsification.
In a retrospective, clinical cohort study of 85 PACD patients (34 with pupillary block, 23 with plateau iris configuration, and 28 with exaggerated lens vault), postoperative iridotrabecular contact (ITC) index (P = 0.031) and area (P = 0.003) showed significant correlations with postoperative IOP fluctuation only in the plateau iris configuration group after phacoemulsification.
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