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Abstract #46890 Published in IGR 13-3
Ultrasound biomicroscopic assessment of angle parameters in patients with primary angle closure glaucoma undergoing phacoemulsification
Dada T; Mohan S; Bali SJ; Bhartiya S; Sobti A; Panda AEuropean Journal of Ophthalmology 2011; 21: 559-565
Purpose. To evaluate the effect of phacoemulsification and foldable intraocular lens (IOL) implantation on biometric determinants of the anterior chamber angle in primary angle closure glaucoma (PACG) using ultrasound biomicroscopy (UBM). Methods. Forty-six eyes of 46 patients with chronic PACG and cataract having a patent laser iridotomy were included in this prospective, interventional case series. Angle parameters were measured using UBM before surgery and 3 months after phacoemulsification with IOL implantation. Intraocular pressure (IOP) was measured by applanation tonometer and records of glaucoma medication administered were maintained. Main outcome measures were IOP, central anterior chamber depth (ACD), trabecular iris angle (TIA), and angle opening distance at 250 and 500 (mu)m from scleral spur (AOD250 and AOD500). Results. The mean age of study participants was 56.5(plus or minus)9.9 years (range 44-75). The preoperative mean IOP was 25.0(plus or minus)5.4 mmHg on maximum antiglaucoma medication, which was reduced to 15.8(plus or minus)3.8 mmHg (p=0.0001) at 3 months. Number of antiglaucoma medications also decreased from 2.4(plus or minus)1.1 to 0.4(plus or minus)1.1 (p=0.0001). There was a significant widening of the anterior chamber angle with the TIA increasing significantly after phacoemulsification (p<0.001) with an associated increase in AOD250, AOD500, and ACD (p<0.001). Conclusions. Phacoemulsification in eyes with PACG results in significant widening of the anterior chamber angle. This results in better IOP control after surgery and decreases the need for glaucoma medications. These findings are of clinical significance in obviating the need for simultaneous filtering surgery in eyes with PACG undergoing phacoemulsification cataract surgery.
T. Dada. Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
Classification:
6.12 Ultrasonography and ultrasound biomicroscopy (Part of: 6 Clinical examination methods)
12.12.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.12 Cataract extraction)
