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Argon laser peripheral iridoplasty for chronic primary angle‐closure and angle‐closure glaucoma in caucasians
Author(s) -
Pillunat Karin R,
Spoerl Eberhard,
Orphal Johanna,
Pillunat Lutz E
Publication year - 2019
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.13878
Subject(s) - gonioscopy , intraocular pressure , ophthalmology , medicine , glaucoma , anterior chamber angle , applanation tonometry , blood pressure , arterial stiffness
Purpose To investigate whether the peripheral thinning and shrinking of the iris as induced with Argon laser peripheral iridoplasty ( ALPI ) has an effect on intraocular pressure ( IOP ), angle structure and 3‐D anterior segment (AS) morphology in Caucasians with chronic primary angle‐closure ( PAC ) and primary angle‐closure glaucoma ( PACG ). Methods Twenty‐four eyes of 24 patients (age 67.7 ± 8.9 years; seven males; 17 females) diagnosed with PAC ( n = 10) or PACG ( n = 14) were assigned for ALPI prior to laser peripheral iridotomy ( LPI ) and consecutively enrolled in this prospective interventional study. Intraocular pressure ( IOP ) was measured with Goldmann applanation tonometry, angle structure with gonioscopy using the Shaffer grading system and AS morphology with the Pentacam rotating Scheimpflug camera prior to and 3 months after ALPI . Intraocular pressure ( IOP )‐lowering medication was not changed during follow‐up. Results Intraocular pressure ( IOP ) changed statistically significantly from 18.8 ± 3.6 to 14.7 ± 3.1 mmHg (p < 0.001). Gonioscopy showed a statistically significant angle widening in all four quadrants: nasally from Shaffer 1.04 ± 0.98 to 2.54 ± 1.1 (p < 0.001), superiorly from 0.39 ± 0.66 to 1.58 ± 1.21 (p < 0.001), temporally from 0.87 ± 1.01 to 2.17 ± 1.24 (p = 0.001) and inferiorly from 1.22 ± 0.74 to 2.75 ± 0.9 (p < 0.001). Pentacam parameters like anterior chamber depth, volume and angle did not increase statistically significantly. Conclusion Argon laser peripheral iridoplasty ( ALPI ) is a safe and effective procedure for reducing appositional angle‐closure and thus IOP in nonacute PAC and PACG patients.