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Prevalence and mechanism of appositional angle closure in acute primary angle closure after iridotomy
Author(s) -
Yeung Barry YM,
Ng Philip WC,
Chiu Thomas YH,
Tsang Chi Wai,
Li Felix CH,
Chi Chung Chai,
Lai Jimmy SM,
Tham Clement CY,
Lam Dennis SC
Publication year - 2005
Publication title -
clinical and experimental ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.3
H-Index - 74
eISSN - 1442-9071
pISSN - 1442-6404
DOI - 10.1111/j.1442-9071.2005.01065.x
Subject(s) - ultrasound biomicroscopy , gonioscopy , medicine , acute angle , ophthalmology , ultrasound , ciliary body , glaucoma , anterior chamber angle , anatomy , radiology
A bstract Purpose: A prospective observational case series to assess the prevalence of appositional angle closure in darkness among iridotomized Chinese eyes after acute primary angle closure (APAC) with the use of both clinical methods and ultrasound biomicroscopy. Methods: Sixteen Chinese patients who had history of APAC and subsequent successful treatment with laser peripheral iridotomy were examined. Fourteen additional control subjects were studied. Gonioscopy and ultrasound biomicroscopic examination were performed in the dark. Gonioscopic appearance of the angle was assessed, and quantitative measurements of the angle from the ultrasound biomicroscopic images were taken. Results: Of the APAC eyes 55.6% had appositionally closed angle clinically and in 38.9% only Schwalbe's line was visi‐ble on gonioscopy. Ultrasound biomicroscopy confirmed structurally different anterior segments between eyes with APAC and the control eyes. In particular, the trabecular‐ciliary‐process distances were markedly different between the two groups. Conclusion: This study documented a high prevalence of appositional closure in iridotomized eyes after APAC in Chinese patients. The anteriorly positioned ciliary body, as documented in these cases by ultrasound biomicroscopy, is the likely mechanism of the angle crowding in this patient population.