Comparing Laser Peripheral Iridotomy to Cataract Extraction in Narrow Angle Eyes Using Anterior Segment Optical Coherence Tomography.
OBJECTIVE
To evaluate the changes in anterior chamber angle (ACA) parameters in primary angle closure (PAC) spectrum eyes before and after cataract extraction (CE) and compare to the changes after laser peripheral iridotomy (LPI) using anterior segment optical coherence tomography (ASOCT).


METHODS
Twenty-eight PAC spectrum eyes of 18 participants who underwent CE and 34 PAC spectrum eyes of 21 participants who underwent LPI were included. ASOCT images with 3-dimensional mode angle analysis scans were taken with the CASIA SS-1000 (Tomey Corp., Nagoya, Japan) before and after CE or LPI. Mixed-effect model analysis was used to 1) compare best-corrected visual acuity, intraocular pressure, and ACA parameters before and after CE; 2) identify and estimate the effects of potential contributing factors affecting changes in ACA parameters; and 3) compare CE and LPI treatment groups.


RESULTS
The increase in average angle parameters (TISA750 and TICV750) was significantly greater after CE than LPI. TICV750 increased by 102% (2.114 [±1.203] μL) after LPI and by 174% (4.546 [± 1.582] μL) after CE (P < 0.001). Change of TICV750 in the CE group was significantly affected by age (P = 0.002), race (P = 0.006), and intraocular lens power (P = 0.037).


CONCLUSIONS
CE results in greater anatomic changes in the ACA than LPI in PAC spectrum eyes. ASOCT may be used to follow anatomic changes in the angle after intervention.
Robert Cizik Eye Clinic, Houston, Texas, United States of America.
Ephrem
E
Melese
Robert Cizik Eye Clinic, Houston, Texas, United States of America.|Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, United States of America.
Jeffrey R
JR
Peterson
Robert Cizik Eye Clinic, Houston, Texas, United States of America.|Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, United States of America.
Robert M
RM
Feldman
Robert Cizik Eye Clinic, Houston, Texas, United States of America.
Laura A
LA
Baker
Robert Cizik Eye Clinic, Houston, Texas, United States of America.|Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, United States of America.
Nicholas P
NP
Bell
Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, United States of America.
Alice Z
AZ
Chuang
Robert Cizik Eye Clinic, Houston, Texas, United States of America.|Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, United States of America.
Lauren S
http://orcid.org/0000-0002-8162-4346
LS
Blieden
D000869:Anterior Eye Segment / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D002387:Cataract Extraction; D003710:Demography; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000601:surgery*; D006068:Gonioscopy; D006801:Humans; D007429:Intraocular Pressure; D007498:Iris / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D007834:Lasers; D008297:Male; D008875:Middle Aged; D041623:Tomography, Optical Coherence / Q000379:methods*; D014129:Trabecular Meshwork / Q000473:pathology / Q000601:surgery