Anterior Segment Optical Coherence Tomography Changes to the Anterior Chamber Angle in the Short-term following Laser Peripheral Iridoplasty

Leong, James C Y; O’Connor, Jeremy; Ang, Ghee Soon; Wells, Anthony P

doi:10.5005/jp-journals-10008-1152

Cited by 17 publications

(6 citation statements)

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“… 18 23 - 25 In the setting of persistent occludable angles after iridotomy, we previously documented that in the short term, additional iri-doplasty brings about significant widening of the ACA. 16 This study does not report on gonioscopic findings as the aim was to quantify changes in angle configuration using AS-OCT.…”

Section: Discussionmentioning

confidence: 99%

“…Numerous other studies have also reported iridoplasty as safe with no significant associated complications. 16 25 28 …”

Section: Discussionmentioning

confidence: 99%

“… 15 Previous work by our group utilized AS-OCT to outline changes in anatomical features of the ACA in the short term following iridoplasty in a cohort of patients with persistent angle closure despite a patent iridotomy. 16 Apart from a case series utilizing gonioscopy, 7 there is a paucity of quantitative descriptions of the medium-term anatomical results of iridoplasty in the published literature. The aim of this study was to use AS-OCT to quantify the medium-term (mean duration 3.2 years) changes in ACA anatomy after iridoplasty in patients with residual angle closure despite a patent iridotomy.…”

Section: Introductionmentioning

confidence: 99%

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Medium-term Anatomical Results of Laser Peripheral Iridoplasty: An Anterior Segment Optical Coherence Tomography Study

Hooshmand

Leong

O’Connor

et al. 2017

Journal of Current Glaucoma Practice

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AimTo evaluate by anterior segment optical coherence tomography (AS-OCT) the medium-term (mean duration 3.2 years) anatomical changes in the anterior chamber angle (ACA) after laser peripheral iridoplasty.Materials and methodsThis is a longitudinal, retrospective case series of 31 eyes of 31 patients with primary angle-closure suspicion, primary angle closure (PAC), or primary angle-closure glaucoma (PACG) who underwent laser peripheral iridoplasty. All patients had persistent iridotrabecular contact (ITC) despite the presence of a patent peripheral iridotomy (PI). An AS-OCT was performed in dark conditions before and after laser iridoplasty. Quadrants of ITC, intraocular pressure (IOP), and the AS-OCT parameters of the temporal and nasal ACAs were measured and analyzed.ResultsPrior to iridoplasty, the average number of quadrants of ITC was 3.3. At the first postiridoplasty visit (mean duration 6.8 weeks), this reduced to 1.7 quadrants but increased to 1.9 by the final follow-up visit (mean duration 3.2 years). Twenty-five patients (80.1%) had less ITC at the first postlaser visit increasing to 27 (87.1%) patients by the final visit. Two (6.5%) required a second iridoplasty, while 3 (9.7%) required cataract surgery. All parameters of angle width showed a statistically significant increase in magnitude. All patients maintained IOP ≥ 21 mm Hg throughout the follow-up period.ConclusionIridoplasty is a useful adjunct in widening the ACA, particularly in those with persistent angle closure after iridotomy but with no cataract. While not successful in all patients, it can act as a temporizing measure to widen the drainage angle until such time that cataract surgery can be performed.Clinical significanceLaser peripheral iridoplasty can be used as an adjunct in angle-closure glaucoma patients with no cataract.How to cite this article: Hooshmand J, Leong JCY, O’Connor J, Ang GS, Wells AP. Medium-term Anatomical Results of Laser Peripheral Iridoplasty: An Anterior Segment Optical Coherence Tomography Study. J Curr Glaucoma Pract 2017;11(3):113-119.

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Section: Discussionmentioning

confidence: 99%

“…Numerous other studies have also reported iridoplasty as safe with no significant associated complications. 16 25 28 …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Medium-term Anatomical Results of Laser Peripheral Iridoplasty: An Anterior Segment Optical Coherence Tomography Study

Hooshmand

Leong

O’Connor

et al. 2017

Journal of Current Glaucoma Practice

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“…Существует множество доказательств значительного увеличения УПК после лазерной иридотомии и лазерной иридопластики при заболеваниях закрытого угла передней камеры по различным параметрам, полученным с помощью AS-визуализации [44][45][46][47][48][49][50][51][52]. При сравнении результатов лазерной иридотомии и факоэмульсификации с имплантацией ИОЛ дополнительная оценка эффективности лечения возможна с использованием ОКТ переднего отрезка для определения ширины УПК [53].…”

Section: визуализация переднего отдела глаза в оценке эффективности лечения болезни закрытого углаunclassified

The Role of Optical Coherence Tomography in the Diagnosis of Angle Closed Diseases of the Anterior Chamber. Part 1: Visualization of the Anterior Segment of the Eye

Курышева¹,

Шарова²

2021

Oftalʹmologiâ

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The purpose of this work is to review the literature data on the role of optical coherence tomography in the diagnosis of diseases of the closed angle of the anterior chamber. An analysis of the modern technical devices use — optical coherence tomography of the anterior segment (AS-OST) and models with a frequency-modulated source (Swept Source) is presented. The advent of new imaging technologies such as SS-OCT is advancing the understanding of the pathogenesis of primary angle closure diseases. Visualization of the structures of the anterior segment of the eye is an important part of the strategy aimed at solving the problem of identifying risk factors, diagnosing, monitoring and evaluating the effectiveness of treatment of diseases of primary angle closure. Qualitative and quantitative data analysis based on optical coherence tomography significantly increases the diagnostic accuracy, which undoubtedly plays a key role in the choice of treatment tactics for the closed angle of the anterior chamber. The interpretation of research results should take into account the strengths and weaknesses of traditional methods and newly developed technologies.Conclusion. Optical coherence tomography of the eye’s anterior segment is a standard in modern diagnostics and evaluation of the effectiveness of treatment of diseases of primary angle closure, taking into account pathogenetic mechanisms.

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“…LPIp is a safe and simple operation, which can effectively open the closed angle [ 6 ]. At present, different spot locations, spot numbers, and energy levels are used according to the personal experience and preference of the ophthalmologist.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of laser peripheral iridoplasty with different energy levels and locations in the treatment of primary angle closure disease assessed by swept-source anterior segment optical coherence tomography

Qin

Zhang

et al. 2023

BMC Ophthalmol

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Background To explore the efficacy and safety of laser peripheral iridoplasty (LPIp) with different energy levels and locations in the treatment of primary angle closure disease (PACD) assessed by swept-source anterior segment optical coherence tomography (AS-OCT). Methods We enrolled patients with PACD following best-corrected visual acuity (BCVA), intraocular pressure (IOP), anterior chamber gonioscopy, ultrasound biomicroscopy(UBM), optic disc OCT, and visual field examinations. After Pentacam and AS-OCT measurements, the patients were randomly divided into four treatment groups for LPIp with two different energy levels (high vs. low energy) and two locations (far from the periphery vs. near the periphery) and combined with laser peripheral iridotomy. BCVA, IOP, pupil diameter, central anterior chamber depth, anterior chamber volume, anterior opening distance (AOD)500, AOD750, trabecular iris angle (TIA)500, and TIA750 in four quadrants before and after laser treatment were compared. Results We followed up 32 patients (64 eyes; average age, 61.80 ± 9.79 years; 8 patients/16 eyes per group) for up to 2 years. The IOP of all enrolled patients was decreased after surgery compared to that before (t = 3.297, P = 0.002), the volume of the anterior chamber was increased (t=-2.047, P = 0.047), and AOD500, AOD750, TIA500, and TIA750 were increased (all P < 0.05). Within-group comparisons showed that BCVA in the low-energy/far-periphery group was improved after surgery (P < 0.05). After surgery, the IOP was decreased in the two high-energy groups, whereas the volume of the anterior chamber, AOD500, AOD750, TIA500, and TIA750 were increased in all groups (all P < 0.05). However, when comparing every two groups, the high-energy/far-periphery group showed a stronger effect on pupil dilation than the low-energy/near-periphery group (P = 0.045). The anterior chamber volume in the high-energy/near-periphery group was larger than that in the high-energy/far-periphery group (P = 0.038). The change in TIA500 was for 6 points smaller in the low-energy/near-periphery group than in the low-energy/far-periphery group (P = 0.038). Other parameters showed no significant group differences. Conclusion LPIp combined with iridotomy can effectively reduce IOP, increase anterior chamber volume, increase chamber angle opening distance, and widen the trabecular iris angle. Intraoperatively, high-energy laser spots positioned one spot diameter from the scleral spur can obtain the best effect and safety. Swept-source AS-OCT can safely and effectively quantify the anterior chamber angle.

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Anterior Segment Optical Coherence Tomography Changes to the Anterior Chamber Angle in the Short-term following Laser Peripheral Iridoplasty

Cited by 17 publications

References 29 publications

Medium-term Anatomical Results of Laser Peripheral Iridoplasty: An Anterior Segment Optical Coherence Tomography Study

Medium-term Anatomical Results of Laser Peripheral Iridoplasty: An Anterior Segment Optical Coherence Tomography Study

The Role of Optical Coherence Tomography in the Diagnosis of Angle Closed Diseases of the Anterior Chamber. Part 1: Visualization of the Anterior Segment of the Eye

Efficacy and safety of laser peripheral iridoplasty with different energy levels and locations in the treatment of primary angle closure disease assessed by swept-source anterior segment optical coherence tomography

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