Abstract

Purpose:To evaluate the effects of prophylactic laser peripheral iridotomy on corneal endothelial cell density and cell morphology in subjects with primary angle closure suspect (PACS) within a one-year follow-up period.Methods:In this quasi-experimental prospective study, from June 2012 to November 2013, thirty-five PACS eyes underwent laser peripheral iridotomy at clinics affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. After obtaining informed consent, specular microscopy was performed at baseline and at 3-month, 6-month and 12-month follow-up visits. Central, nasal and temporal endothelial cell counts and cell morphology were evaluated via non-contact specular microscopy.Results:The mean subject age was 53.4 ± 7.9 years, and the majority of subjects were women (88.2%). The mean central corneal endothelial cell count prior to laser peripheral iridotomy was 2528 ± 119.2, and this value changed to 2470 ± 175.9, 2425 ± 150.6, and 2407 ± 69.02 at the 3-month, 6-month, and 12-month follow-up visits, respectively; these differences did not reach statistical significance. Additionally, the changes in the number of cells, the hexagonality of cells, and the coefficient of variation (CV) in the central, nasal, and temporal areas were not significant.Conclusion:In PACS eyes, we did not find a decline in corneal endothelial cell density or a change in cell morphological characteristics, including cell hexagonality and CV, in the central, nasal, and temporal regions of the cornea in any of our subjects over a one-year follow-up period.

Highlights

  • IntroductionIt is unsurprising that primary angle closure glaucoma (PACG) is estimated to cause blindness in two to five times as many subjects as primary open angle glaucoma.[4,5] Studies revealed that 22% of subjects with primary angle closure suspect (PACS) may progress to primary angle closure (PAC) and that 28.5% of PAC subjects may develop PACG within 5 years if no treatment is prescribed.[6]

  • There is controversy regarding the safety of this procedure to the corneal endothelium, especially with respect to the relationship between laser peripheral iridotomy and corneal decompensation.[13,14,15,16]

  • We assessed the effects of prophylactic laser peripheral iridotomy on corneal endothelial cell density, hexagonality, and coefficient of variation (CV) in primary angle closure suspect (PACS) eyes over a 12‐month follow‐up period

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Summary

Introduction

It is unsurprising that primary angle closure glaucoma (PACG) is estimated to cause blindness in two to five times as many subjects as primary open angle glaucoma.[4,5] Studies revealed that 22% of subjects with primary angle closure suspect (PACS) may progress to primary angle closure (PAC) and that 28.5% of PAC subjects may develop PACG within 5 years if no treatment is prescribed.[6]

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