Association of Lens Anterior and Posterior Capsular Bag Laxity With Clinical Characteristics in Primary Angle Closure Disease.

Précis: The presence of anterior capsular laxity caused acute angle closure glaucoma, and posterior capsular laxity alone was associated with a chronic progressive course, revealing new insight into the pathogenesis of primary angle closure disease.

Purpose

This study investigates the association between anterior or posterior capsular bag laxity during cataract surgery and clinical characteristics in patients with primary angle closure disease (PACD).

Methods

This retrospective study included 137 patients (200 eyes) diagnosed with PACD and undergoing phacoemulsification cataract surgery. Patients were categorized into 4 groups based on the condition of the capsular bag: loose anterior capsular bag (LACB), loose posterior capsular bag (LPCB), loose anterior and posterior capsular bag (LAPCB), and stable capsular bag (SCB). We analyzed the association of capsular bag laxity with clinical characteristics using ANOVA and χ 2 .

Results

Significant differences were observed among the groups in terms of sex, disease duration, anterior chamber depth (ACD), lens vault (LV), and lens Front R, while age, PACD classification, mean corneal power, axial length, and lens thickness showed no significant variation. The ACD was notably deeper in the LPCB and SCB groups. The LV was higher, and the lens Front R was smaller in the LACB and LAPCB groups. Lens Back R varied more in the LPCB group. Anterior capsular laxity, alone or combined with posterior capsular laxity, was more prevalent in cases of acute angle closure glaucoma (ACG) (56.0%) compared with chronic ACG (19.4%). Posterior capsule laxity alone was more common in chronic ACG (45.2%) than in acute ACG (10.7%).

Conclusion

The presence of anterior capsular laxity, with or without posterior capsular laxity, is associated with the development of acute ACG, whereas posterior capsular laxity alone is typically linked to the development of chronic ACG.