Changes in Iridotrabecular Contact and Intraocular Pressure after Phacoemulsification in Primary Angle-Closure...

Area of Science:

• Ophthalmology
• Anterior Segment Surgery
• Glaucoma Research

Background:

• Primary angle-closure disease (PACD) encompasses a spectrum of conditions.
• Lens extraction is a treatment option for PACD.
• Assessing post-operative outcomes is crucial for managing PACD.

Purpose of the Study:

• To compare changes in swept-source anterior-segment optical coherence tomography (SS AS-OCT) parameters and intraocular pressure (IOP) control after lens extraction in PACD.
• To evaluate outcomes across different severities of PACD.

Main Methods:

• 92 eyes from 92 PACD patients undergoing lens extraction were analyzed.
• IOP was measured preoperatively and at multiple time points postoperatively.
• SS AS-OCT was performed preoperatively and 1 month postoperatively.
• Patients were divided into PAC suspect/PAC (Group A) and PAC glaucoma (Group B).

Main Results:

• Both groups showed improved anterior chamber angles post-surgery.
• Group B (PAC glaucoma) had a significantly greater residual iridotrabecular contact (ITC) index (10.7 ± 12.1 vs 5.6 ± 7.0).
• A greater change in ITC index correlated with greater IOP reduction (β = 0.429, p < 0.001).
• Group B required more glaucoma medications postoperatively (0.9 ± 0.8 vs 0.2 ± 0.7).

Conclusions:

• Eyes with PAC glaucoma exhibit a higher residual ITC index after lens extraction.
• PAC glaucoma patients require more medications to maintain IOP control compared to other PACD spectra.
• Lens extraction effectively alters anterior segment parameters in PACD, but residual contact remains a factor in glaucoma management.