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Keywords:

  • angle closure;
  • anterior segment optical coherence tomography;
  • laser peripheral iridotomy

Abstract

Background:  To evaluate by anterior segment optical coherence tomography (AS-OCT) the changes in the anterior chamber structures in Caucasian eyes after laser peripheral iridotomy (PI).

Methods:  Retrospective study of consecutive Caucasian primary angle closure suspect (PACS), primary angle closure (PAC) or primary angle closure glaucoma (PACG) patients who underwent laser PI over a 25-month period at a specialist glaucoma practice. The AS-OCT images of the temporal and nasal angles (in light and dark) before and after laser PI were analysed. The parameters studied were trabecular-iris angle (TIA), angle opening distance (AOD), trabecular-iris space area (TISA), trabecular-iris contact length (TICL), iris thickness (IT) and maximum iris bow height (MIBH).

Results:  Images of 71 eyes of 71 patients were assessed. The mean age at laser PI was 60.3 ± 10.0 years. Forty (56.3%) were women, and 14 (19.7%) had PACG. The mean time from laser PI to the follow-up AS-OCT scan was 5.92 ± 3.22 weeks. The IT did not alter significantly after laser PI, but there were significant increases in the TIA, AOD and TISA, as well as a significant decrease in MIBH, in both light and dark. There was no difference in the magnitude of change seen between the temporal and nasal angles, or between PACS/PAC and PACG eyes.

Conclusion:  In Caucasian eyes, laser PI resulted in significant angle widening (increased TIA, AOD and TISA) and iris profile flattening (decreased MIBH) at the temporal and nasal angles based on AS-OCT imaging in both light and dark.