Clinical Study
Eye (2007) 21, 735–741; doi:10.1038/sj.eye.6702317; published online 17 March 2006
Ultrasound biomicroscopic quantification of the change in anterior chamber angle following laser peripheral iridotomy in early chronic primary angle closure glaucoma
No author has any proprietary interest in any of the products mentioned in this paper.
S Kaushik1, S Kumar1, R Jain1, R Bansal1, S S Pandav1 and A Gupta1
1Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
Correspondence: S Kaushik, Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh- 160012, India. Tel: +91 172 2747837; Fax: +91 172 2744401. E-mail: sushmita_kaushik@yahoo.com
Received 31 October 2005; Accepted 30 January 2006; Published online 17 March 2006.
Abstract
Aims
To prospectively evaluate by ultrasound biomicroscopy (UBM) and gonioscopy the anterior chamber angle widening following laser peripheral iridotomy (LPI) in eyes with early chronic primary angle closure glaucoma (CACG).
Methods
A total of 55 eyes of 55 patients with CACG presenting with less than 180° peripheral anterior synechiae (PAS) were enrolled in the study. Angles were assessed by gonioscopy (Shaffer's grading) and UBM, before and 4 weeks after LPI. The angle opening distance at 250 and 500 
m from the scleral spur (AOD 250 and AOD 500) was computed. Results were analysed using the Wilcoxon signed-rank test.
Results
In the quadrant with LPI, the mean gonioscopy grade increased significantly from 0.45 to 1.45 (P<0.001) and the mean AOD 250 and AOD 500 increased from 38.5
25.9 to 83.548.4 m (P<0.001) and 110.280.9 to 170.683.4 m (P<0.001), respectively. The angles widened significantly in the opposite quadrant on UBM (AOD 250: 48.831.5–82.743.9 m, P<0.001; AOD 500:117.265.5–172.281.7 m; P<0.001), but the median gonioscopy grade remained unchanged.
Conclusions
LPI significantly widened the anterior chamber angle in the quadrant with LPI and the quadrant furthest away in patients of CACG with established glaucomatous damage. This change was much better appreciated by the UBM than gonioscopy.
Keywords:
ultrasound biomicroscopy, laser peripheral iridotomy, anterior chamber angle, chronic primary angle closure glaucoma
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