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INITIAL EVALUATION OF ANTERIOR CHAMBER ANGLE CHANGES FOLLOWING LASER PERIPHERAL IRIDOTOMY AND PHACOEMULSIFICATION IN PATIENTS WITH PRIMARY ANGLE CLOSURE SUSPECT
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Abstract
Objective: To compare anterior chamber angle changes after laser peripheral iridotomy (LPI) and phacoemulsification (Phaco) using anterior segment optical coherence tomography (AS-OCT), and to evaluate the rate of residual angle closure by gonioscopy. Methods: A prospective cohort study was conducted on 66 eyes of 42 patients with primary angle-closure suspects (PACs) and grade I–II cataracts, treated with LPI (n = 33) or Phaco (n = 33) at Can Tho Ophthalmology Hospital from February 2025 to May 2025. Anterior chamber angle parameters were measured by gonioscopy and AS-OCT before and 4 weeks after treatment. Results: At 4 weeks, both groups showed significant increases in angle-opening distance, trabecular–iris angle, and trabecular–iris space area, with greater improvement in the Phaco group. Mean angle width (Shaffer) reached 3.98 in the Phaco group compared with 2.98 in the LPI group (p < 0.001). Residual angle closure ≥ 2 quadrants and ≥ 1 quadrant occurred in 42.4% and 57.6% of LPI eyes, respectively, while no cases were observed in the Phaco group. Both groups showed significant reductions in iris curvature, lens vault, and pupil diameter, along with increased anterior chamber depth (all p < 0.001 for all), with more pronounced changes in the Phaco group (p < 0.001). Conclusion: Phacoemulsification is more effective than LPI in widening the anterior chamber angle and deepening the anterior chamber in PACs patients.
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Keywords
Primary angle-closure suspect (PACs), Laser peripheral iridotomy (LPI), Phacoemulsification, Gonioscopy, Anterior segment optical coherence tomography (AS-OCT).
References
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