advertisement
Abstract #26603 Published in IGR 12-3
Prophylactic laser peripheral iridotomy and cataract progression
Yip JLY; Nolan WP; Gilbert CE; Uranchimeg D; Baassanhuu J; Lee PS; Khaw PT; Johnson GJ; Foster PJEye 2010; 24: 1127-1135
Purpose To determine whether prophylactic laser peripheral iridotomy (LPI) for primary angle closure (PAC) is associated with cataract progression. Methods In 1999, Mongolian volunteers aged (greater-than or equal to)50 years were invited to participate in a longitudinal study. Glaucoma was excluded in all participants and 712 of them were selected to undergo a full ophthalmic examination as part of the study protocol. Lenses were graded and PAC diagnosed using international classification systems. In 2005, all traced participants underwent a similar dilated examination. Diagnosis of cataract progression was based on the inter-observer variation 2 standard deviations. The association between LPI at baseline and cataract progression was assessed using (Xi)(2) -test and logistic regression. Results Of 712 participants, 158 were diagnosed with occludable angles and treated with LPI. In 2005, 137 participants (19.2%) had died, 315 (315/5755=4.8%) were traced, and dilated examination was performed on 276 (48%) of them. Progression of nuclear opacity (NO), cortical, and posterior subcapsular (PSC) opacities were evident in 40 (14.5%, 95% confidence interval (CI)=10.6-19.2%), 89 (32.2%, 95% CI=26.8-38.1%), and 11 participants (4.0%, 95% CI=2.0-7.0%), respectively. Although NO was more likely to progress in those with LPI in a crude analysis (odds ratio (OR)=2.02, 95% CI=1.00-4.11, P=0.05), no evidence of an independent association was detected in multivariate analysis adjusting for age, sex, and baseline Schaffer grading (adjusted OR1.24, 0.41-3.75, P0.7). There was no evidence of an association between LPI and progression of PSC or cortical opacities. Conclusions There is no evidence that prophylactic LPI is independently associated with cataract progression in this study.
J. L. Y. Yip. Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Robinson Way, Cambridge, United Kingdom. jlyy2@medschl.cam.ac.uk
Classification:
12.2 Laser iridotomy (Part of: 12 Surgical treatment)
9.3.5 Primary angle closure (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)
9.4.4.2 Glaucomas associated with cataracts (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.4 Glaucomas associated with disorders of the lens)
