急性閉塞隅角緑内障における水晶体摘出術後の前眼部変化：シェーグレン・プラチドトモグラフィーによる評価

This study aimed to evaluate changes in anterior segment morphology and intraocular pressure (IOP) in patients with acute angle-closure glaucoma (AACG) following early phacoemulsification, using Scheimpflug-Placido disc tomography.

In this retrospective cohort study, In this retrospective cohort study, 32 eyes of 32 phakic patients diagnosed with AACG and referred to a tertiary hospital between 2021 and 2023 were included. After medical stabilization of IOP and inflammation, all patients underwent cataract surgery within one month of the acute attack. Anterior segment parameters were assessed using Scheimpflug-Placido disc tomography before and one month after surgery. Paired t-tests were used for statistical analysis.

The mean age of patients was 65.76 ± 9.63 years. Postoperatively, best corrected visual acuity improved significantly (pre-op: 0.81 ± 0.92 logMAR; post-op: 0.18 ± 0.30 logMAR; p < 0.01). Mean IOP decreased by 22.8 ± 3.45 mmHg (p < 0.01). Significant increases were observed in iridocorneal angle (from 24.62 ± 9.59 to 46.20 ± 10.93 degrees), anterior chamber depth (from 1.34 ± 0.65 mm to 3.02 ± 0.82 mm), and anterior chamber volume (from 98.01 ± 28.62 mm³ to 145.87 ± 27.27 mm³), all with p < 0.01. Central corneal thickness decreased slightly but significantly (from 579.80 ± 47.48 µm to 556.80 ± 47.29 µm; p = 0.03).

Early lens extraction in AACG significantly improves anterior segment parameters and lowers IOP. Scheimpflug-Placido disc tomography is a useful non-invasive tool to quantify these changes.