Comparing Laser Peripheral Iridotomy to Cataract Extraction in Narrow Angle Eyes Using Anterior Segment Optical Coherence Tomography

• Published in: PloS one Vol. 11; no. 9; p. e0162283
• Main Authors: Melese, Ephrem, Peterson, Jeffrey R., Feldman, Robert M., Baker, Laura A., Bell, Nicholas P., Chuang, Alice Z., Blieden, Lauren S.
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 08.09.2016; Public Library of Science (PLoS)
• Subjects: Acuity; Anterior chamber; Anterior Eye Segment - pathology; Anterior Eye Segment - physiopathology; Anterior Eye Segment - surgery; Biology and Life Sciences; Cataract Extraction; Cataracts; Clinical outcomes; Demography; Dimensional analysis; Engineering and Technology; Eye; Eye (anatomy); Eye lens; Eye surgery; Female; Glaucoma; Glaucoma, Angle-Closure - surgery; Gonioscopy; Human subjects; Humans; Intraocular Pressure; Iris - pathology; Iris - physiopathology; Iris - surgery; Lasers; Male; Medicine and Health Sciences; Middle Aged; Optic nerve; Optical Coherence Tomography; Optics; Parameter identification; Research and Analysis Methods; Studies; Tomography; Tomography, Optical Coherence - methods; Trabecular Meshwork - pathology; Trabecular Meshwork - surgery; Visual acuity; United States > US; Texas
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0162283

To evaluate the changes in anterior chamber angle (ACA) parameters in primary angle closure (PAC) spectrum eyes before and after cataract extraction (CE) and compare to the changes after laser peripheral iridotomy (LPI) using anterior segment optical coherence tomography (ASOCT). Twenty-eight PAC spectrum eyes of 18 participants who underwent CE and 34 PAC spectrum eyes of 21 participants who underwent LPI were included. ASOCT images with 3-dimensional mode angle analysis scans were taken with the CASIA SS-1000 (Tomey Corp., Nagoya, Japan) before and after CE or LPI. Mixed-effect model analysis was used to 1) compare best-corrected visual acuity, intraocular pressure, and ACA parameters before and after CE; 2) identify and estimate the effects of potential contributing factors affecting changes in ACA parameters; and 3) compare CE and LPI treatment groups. The increase in average angle parameters (TISA750 and TICV750) was significantly greater after CE than LPI. TICV750 increased by 102% (2.114 [±1.203] μL) after LPI and by 174% (4.546 [± 1.582] μL) after CE (P < 0.001). Change of TICV750 in the CE group was significantly affected by age (P = 0.002), race (P = 0.006), and intraocular lens power (P = 0.037). CE results in greater anatomic changes in the ACA than LPI in PAC spectrum eyes. ASOCT may be used to follow anatomic changes in the angle after intervention.