title: Peripheral yttrium aluminium garnet (YAG) iridotomy versus phacoemulsification in primary angle closure: prospective comparative study.
abstract: OBJECTIVE
  A study was designed to determine and describe the changes induced in the anterior segment of the eye and the intraocular pressure (IOP) after laser peripheral iridotomy (LPI) versus phacoemulsification in primary angle closure suspects (PACS) and primary angle closure (PAC).
  
  
  METHODS
  Forty-seven eyes (47 patients) with Shaffer gonioscopy 0-II were included and split into 2 groups: cataract surgery (n=29) or LPI (n=18), depending on the lens sclerosis and visual acuity. Tonometry, gonioscopy, funduscopy, and automated measurements of the anterior chamber by Pentacam were performed before the intervention, and one and 3 months after the technique.
  
  
  RESULTS
  Phacoemulsification reduces IOP after one and 3 months (P<.01). LPI reduces IOP after 3 months (P<.04), and after one month (P<.38). IOP was 16.2mmHg (SD: 3.59) in the phacoemulsification group vs. 16.83mmHg (SD: 2.36) in the LPI group after one month (P=.4), and 15.52 (SD: 2.95) vs. 16.05 (SD: 2.46) in the third month (P=.5). There were no significant differences in the antiglaucoma drugs. Shaffer gonioscopy grading was greater in the phacoemulsification group vs. in the LPI group one and 3 months after the intervention (P=.01). The highest difference between both techniques was found in the superior quadrant. The anterior chamber depth, angle and volume by Pentacam were wider in the phacoemulsification group after one and 3 months (P<.01).
  
  
  CONCLUSIONS
  Although phacoemulsification and LPI could both be effective techniques in the prevention of pupillary block in PAC, faster and greater amplitude of the angle and the anterior chamber can be obtained after phacoemulsification than after LPI.
authors: Servicio de Oftalmología, IISFJD, Hospital Rey Juan Carlos, Móstoles, Madrid, España. Electronic address: elejarrin@hotmail.com.
authors: E
authors: E
authors: Jarrín
authors: Servicio de Oftalmología, IRYCIS, Hospital Ramón y Cajal, Madrid, España.
authors: C
authors: C
authors: Cabarga-Nozal
authors: Servicio de Oftalmología, IRYCIS, Hospital Ramón y Cajal, Madrid, España.
authors: A
authors: A
authors: Almendral
authors: Servicio de Oftalmología, IRYCIS, Hospital Ramón y Cajal, Madrid, España.
authors: F J
authors: FJ
authors: Muñoz-Negrete
mesh_terms: D000368:Aged; D000535:Aluminum / Q000627:therapeutic use*; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000601:surgery*; D006801:Humans; D007498:Iris / Q000601:surgery*; D053685:Laser Therapy; D008297:Male; D018918:Phacoemulsification; D011446:Prospective Studies; D015019:Yttrium / Q000627:therapeutic use*
chemical_list: C503779:yttrium-aluminum-garnet; D015019:Yttrium; D000535:Aluminum
keywords: Anterior chamber angle; Anterior chamber depth; Anterior chamber volume; Cataract surgery; Cierre angular primario; Facoemulsificación; Iridotomía periférica láser; Narrow angle; Peripheral YAG iridotomy; Phacoemulsification; Primary angle closure; Primary angle closure suspects; Profundidad de cámara anterior; Sospecha de cierre angular primario; Volumen de cámara anterior; Ángulo camerular; Ángulo estrecho