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Abstract #51434 Published in IGR 14-4
Long-term changes in endothelial cell counts after early phacoemulsification versus laser peripheral iridotomy using sequential argon:YAG laser technique in acute primary angle closure
Park HY; Lee NY; Park CK; Kim MSGraefe's Archive for Clinical and Experimental Ophthalmology 2012; 250: 1673-1680
OBJECTIVE: To compare the change in endothelial cell counts (ECC) after early phacoemulsification and laser peripheral iridotomy (LPI) using sequential argon:yttrium-aluminum-garnet (YAG) laser technique for the treatment of acute primary angle closure (APAC). METHODS: This was a retrospective chart review, case-control study; 86 APAC patients were enrolled. Sixteen patients who underwent early phacoemulsification with intraocular lens implantation and 32 patients who underwent LPI were matched by propensity score analysis. All subjects underwent a complete ophthalmic examination, including intraocular pressure (IOP) measurements, optic disc examinations, and gonioscopy. ECC were acquired at the center of the cornea with a noncontact specular microscope before treatment, and at 1, 6, 12, and 24 months following phacoemulsification or LPI. RESULTS: The mean follow-up was 26.1 ± 4.7 months in the phacoemulsification group and 26.3 ± 4.5 months in the LPI group. After intervention, the changes in anterior chamber depth and Shaffer grading by gonioscopy were significantly different between groups. ECC were not different before treatment; however, after phacoemulsification or LPI at 12 months (2280 ± 320 vs 1993 ± 380 cells/mm(2)) and 24 months (2113 ± 333 vs 1880 ± 422 cells/mm(2)), there was a significant difference between the two groups (P = 0.040 and P = 0.032 respectively). Regression analysis showed that anterior chamber depth at baseline (P = 0.041) and intervention modality (phacoemulsification vs LPI; P < 0.001) were significantly related to the change in ECC. CONCLUSIONS: Early phacoemulsification showed lower endothelial cell loss than did LPI in the treatment of APAC after a 2-year follow-up. In terms of ECC, early phacoemulsification could be a better intervention modality for APAC.
Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 505 Banpo-dong, Seocho-ku, Seoul, 137-701, Korea.
Full articleClassification:
12.2 Laser iridotomy (Part of: 12 Surgical treatment)
9.3.1 Acute primary angle closure glaucoma (pupillary block) (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)
2.2 Cornea (Part of: 2 Anatomical structures in glaucoma)