Abstract
Aim: The aim of this study was to investigate the changes in anterior segment parameters as assessed by ultrasound biomicroscopy (UBM) after laser peripheral iridotomy (LPI) and to propose a prediction equation for the width of the angle after LPI.Design: This was a prospective study.Participants: The participants included 100 subjects with primary angle closure suspect (PACS).Methods: Anterior segment UBM parameters were measured, whereas AOD750 was chosen to indicate the width of the angle associated with gonioscopic angle closure, as found in a prior study.Main Outcome Measures: Angle parameters, iris parameters, anterior chamber parameters and ciliary body parameters.Results: All angle parameters increased after LPI, including the mean angle opening distance at 750 μm (AOD750), mean angle opening distance at 500 μm from the scleral spur (AOD500), mean angle opening distance at 750 μm from the scleral spur (AOD750), and mean angle recess area at 750 μm from the scleral spur (ARA750). Among iris parameters and ciliary body parameters, the iris thickness at 2,000 μm (IT2000), iris curvature (IC), and trabecular-ciliary process distance (ICPD) were reduced after LPI. The final equation consisted of four parameters: anterior chamber depth (ACD), iris thickness at 750 μm from the scleral spur (IT750), AOD750, and lens vault (LV). This equation explained 42.7% of the variability in the angle opening indicator AOD750 after LPI, whereas in the plateau iris configuration subgroup, the accuracy of the prediction equation reached the highest a maximum of 68.6%.Conclusions: There was an increase in angle opening and iris flattening after LPI. An equation involving four angle parameters was constructed, this equation which could explained 42.7% of the variability in the angle opening indicator AOD750 after LPI whereas in the plateau iris configuration subgroup, the accuracy of the prediction equation reached a maximum of 68.6%.
Highlights
The incidence of angle-closure glaucoma is between 1.1% and 1.6% in China
A previous study found that for every 0.1 mm decrease in the angle opening distance at 750 μm from the scleral spur (AOD750), the odds of developing gonioscopic angle closure increased by a factor of 3.27 [5]
We used ultrasound bomicroscopy (UBM) to establish the relationship between the angle opening distance after Laser peripheral iridotomy (LPI) and baseline parameters, and we proposed a predictive equation for the angle opening distance after LPI to predict the post-procedural effect of this technique
Summary
The incidence of angle-closure glaucoma is between 1.1% and 1.6% in China. Laser peripheral iridotomy (LPI) is an option for the treatment of PACS because it can establish a channel, relieve the pupil block component, and flatten the iris plane, increasing the width of the anterior chamber angle [3, 4]. A previous study found that for every 0.1 mm decrease in the angle opening distance at 750 μm from the scleral spur (AOD750), the odds of developing gonioscopic angle closure increased by a factor of 3.27 [5]. To predict the post-procedural effect of LPI, it is necessary to establish a prediction equation for the degree of angle opening after LPI based on the morphological structure of the eye
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