Anterior Segment Optical Coherence Tomography Parameters in Phacomorphic Angle Closure and Mature Cataracts

Mansouri, M R; Ramezani, Farshid; Moghimi, Sasan; Tabatabaie, Ali; Abdi, Fatemeh; He, Mingguang; Lin, Shan

doi:10.1167/iovs.14-14748

Cited by 39 publications

(37 citation statements)

References 28 publications

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“…4,6,13,27 In a cross-sectional study by Nongpiur et al, 9 LV was found to be one of the strongest predictors of PACG. In eyes with greater LV, the iris is pushed more anteriorly, leading to a crowded angle.…”

Section: Discussionmentioning

confidence: 95%

“…Mansouri et al 13 did not find any significant difference between mature cataracts and phacomorphic angle closures in terms of AL. They proposed that the anterior segment dimensions of the eye might play a more important role in the development of phacomorphic angle closure.…”

Section: Figurementioning

confidence: 86%

“…26,31 Researchers have demonstrated that phacomorphic angle closure is a condition that can happen in eyes with both deep and shallow chambers. 27 However, Mansouri et al 13 demonstrated that eyes with ACD <2.6 mm had an OR of 7.9 for developing phacomorphic angle closure compared with eyes that have mature cataracts. In our patients, phacomorphic angle closure eyes were 0.36 mm shallower than APAC eyes.…”

Section: Discussionmentioning

confidence: 99%

“…2,4 However, only a few studies have evaluated factors associated with phacomorphic angle closure. 5,13 Mansouri et al 13 reported that a small anterior segment is the single most important parameter to predispose mature eyes to develop an acute attack. Both pupillary block and increasing lens vault mechanism have possible roles in the development of phacomorphic angle closure and APAC, suggesting that lens extraction can be considered as a treatment for both conditions by addressing both mechanisms.…”

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confidence: 99%

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Comparison of Anterior Segment-Optical Coherence Tomography Parameters in Phacomorphic Angle Closure and Acute Angle Closure Eyes

Moghimi

Ramezani

et al. 2015

Invest. Ophthalmol. Vis. Sci.

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Section: Discussionmentioning

confidence: 95%

Section: Figurementioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Comparison of Anterior Segment-Optical Coherence Tomography Parameters in Phacomorphic Angle Closure and Acute Angle Closure Eyes

Moghimi

Ramezani

et al. 2015

Invest. Ophthalmol. Vis. Sci.

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“…We believe that much of the hypotensive effect arising from lens extraction is related to the anatomical configuration of the anterior chamber and the degree of angle opening, in addition to the functional reserve of the trabecular meshwork. In this context, eyes with shallower chambers, greater influence of the lens component (greater lens vaults), narrower angles without extensive synechiae, and good trabecular function could most benefit from cataract surgery in terms of IOP reduction (21,22) . This seems to explain the modest effect of phacoemulsification in controlling IOP in eyes with open-angle glaucoma.…”

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confidence: 99%

Cataract surgery alone cannot be considered an IOP-lowering procedure for open-angle glaucoma patients: an evidence-based perspective

Prata¹,

Ushida²,

Dorairaj³

2015

Arquivos Brasileiros De Oftalmologia

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Due to the significant coexistence of cataract and glaucoma, cataract surgery has become a routine procedure in a glaucoma surgeon's practice (1)(2)(3)(4) . The indication of cataract surgery in glaucoma patients usually differs from that in ordinary cases, either because of the intraoperative technique and perioperative care or because of the expected results. The approach also varies significantly among patients with glaucoma, depending on various factors such as disease stage, preoperative intraocular pressure (IOP), number of medications, gonioscopy appearance, patient's age, previous ocular surgery, comorbidities, and others. Therefore, it is essential that every surgeon recognizes the influence of cataract surgery on IOP control in each type of glaucoma, aiming, above all, to mitigate the risk of losing control of the disease.The relationship between glaucoma and cataract surgery has been investigated in several glaucoma studies (1)(2)(3) . More recently, the topic began to be approached by cataract specialists in original articles, editorials, and meetings (5)(6)(7) . In this context, much has been discussed about the hypotensive effect of cataract surgery in patients with glaucoma or ocular hypertension. On analyzing the literature carefully, we found that most of the articles that evaluated the effects of phacoemulsification with intraocular lens implantation in patients with glaucoma included eyes with angle-closure glaucoma (either the chronic or acute form of the disease) (8)(9)(10)(11) . Although little has been studied about the hypotensive effect of cataract surgery in eyes with open-angle glaucoma until now, the consistently good results reported on average in cases of angle-closure led to the idea that cataract surgery would be an effective IOP-lowering procedure for all cases of glaucoma (9,11) . In our opinion, this assumption seems dangerous, and to date, has no strong basis in the literature.When focusing on previous articles that include patients with open-angle glaucoma, we come across scant data and few good studies. Most of the available studies are based on non-comparative case series with retrospective analysis. In general, a modest IOP reduction was observed after uncomplicated phacoemulsification in these patients. Among the more rigorous studies, the mean long-term changes in IOP values varied between 1.5 and 2 mmHg (11)(12)(13) . For example, in a recent study by Slabaugh et al. (12) , over 150 patients with open-angle glaucoma controlled with medication underwent cataract surgery. After one year of follow-up, IOP was reduced by an average of 1.8 ± 3.1 mmHg. Although significant from a statistical point of view, it is questionable whether this percentage reduction in IOP is clinically meaningful. When compared with the preoperative period, there was no significant change in the number of medications after cataract surgery. In this study, perhaps the most alarming report was the fact that almost 40% of these glaucoma patients lost IOP control during the first year after cataract sur...

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Anterior Segment Optical Coherence Tomography and Glaucoma

Moghimi

Safizadeh

Jiun

2020

Diagnostics in Ocular Imaging

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Anterior Segment Optical Coherence Tomography Parameters in Phacomorphic Angle Closure and Mature Cataracts

Abstract: Anterior chamber depth, ACA, AOD750, and LV are powerful indicators in differentiating phacomorphic angle closure eyes from those with mature cataract and their fellow eyes.

Cited by 39 publications

References 28 publications

Comparison of Anterior Segment-Optical Coherence Tomography Parameters in Phacomorphic Angle Closure and Acute Angle Closure Eyes

Comparison of Anterior Segment-Optical Coherence Tomography Parameters in Phacomorphic Angle Closure and Acute Angle Closure Eyes

Cataract surgery alone cannot be considered an IOP-lowering procedure for open-angle glaucoma patients: an evidence-based perspective

Anterior Segment Optical Coherence Tomography and Glaucoma

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