Quantitative assessment of changes in anterior segment morphology after argon laser peripheral iridoplasty: findings from the EARL study group.
Lim Dawn K, Chan Hwei W, Zheng Ce, Aquino Maria C, Wong Wan Ling, Ritch Robert, Chew Paul Tk
AI Summary
ALPI significantly widened the anterior chamber angle and lowered IOP in eyes with residual angle closure post-LPI, suggesting its clinical utility in these cases.
Abstract
Importance
Argon laser peripheral iridoplasty (ALPI) could be effective in widening residual angle closure following laser peripheral iridotomy (LPI).
Background
We investigated changes in angle parameters following ALPI and its safety profile in this study.
Design
Retrospective, observational case series.
Participants
The records from a single centre, of 36 patients (60 eyes) who underwent ALPI, for residual angle closure following LPI, were reviewed.
Methods
We analysed anterior chamber parameters in anterior segment optical coherence tomography (ASOCT) images using customized software pre- and post-ALPI. Paired t-test was used to compare changes.
Main outcome measures
ASOCT parameters analysed included angle opening distance (AOD 500 and 750), trabecular iris surface area (TISA 500 and 750), anterior chamber width (ACW), anterior chamber volume (ACV), angle recess area (ARA), anterior chamber area (ACA), anterior chamber depth (ACD) and lens vault (LV).
Results
There was a mean increase in AOD 500 (0.05 vs. 0.16 mm, P < 0.001), AOD 750 (0.15 vs. 0.27 mm, P < 0.001), TISA 500 (0.010 vs. 0.038 mm 2 , P < 0.001), TISA 750 (0.039 vs. 0.102 mm 2 , P < 0.001), ACV (89.76 vs. 102.25 mm 3 , P = 0.01), ARA 500 (0.015 vs. 0.033 mm 2 , P < 0.001) and ARA 750 (0.044 vs. 0.088 mm 2 , P < 0.001). There was no significant change in ACW, ACD, ACA and LV. Mean intraocular pressure (IOP) decreased post-ALPI (17.2 vs. 15.7 mmHg, P = 0.002). The mean follow-up duration was 2.1 years (range 0.5-5 years).
Conclusions and relevance: ALPI results in changes to the angle morphology and lowered IOP in eyes with residual angle closure. Our findings suggest a possible role for ALPI in eyes with residual angle closure following peripheral iridotomy.
MeSH Terms
Shields Classification
Key Concepts5
Argon laser peripheral iridoplasty (ALPI) significantly increased angle opening distance (AOD 500) from 0.05 mm to 0.16 mm (P < 0.001) in eyes with residual angle closure following laser peripheral iridotomy (LPI).
Argon laser peripheral iridoplasty (ALPI) significantly increased trabecular iris surface area (TISA 500) from 0.010 mm2 to 0.038 mm2 (P < 0.001) in eyes with residual angle closure following laser peripheral iridotomy (LPI).
Argon laser peripheral iridoplasty (ALPI) significantly increased anterior chamber volume (ACV) from 89.76 mm3 to 102.25 mm3 (P = 0.01) in eyes with residual angle closure following laser peripheral iridotomy (LPI).
Argon laser peripheral iridoplasty (ALPI) significantly decreased mean intraocular pressure (IOP) from 17.2 mmHg to 15.7 mmHg (P = 0.002) in eyes with residual angle closure following laser peripheral iridotomy (LPI).
There was no significant change in anterior chamber width (ACW), anterior chamber depth (ACD), anterior chamber area (ACA), and lens vault (LV) following argon laser peripheral iridoplasty (ALPI) in eyes with residual angle closure following laser peripheral iridotomy (LPI).
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