Evaluation of Anterior Segment Parameters by using Pentacam and Gonioscopy after Prophylactic Laser Peripheral Iridotomy among primary angle close suspect
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Abstract
Aim: To evaluate laser Perifheral iridotomy (LPI) changes on anterior segment parameters (ASP) among primary angle closure suspect (PACS) using the Pentacam and gonioscopy.
Methods: This comparative, prospective, Interventional Study was conducted between August 2019 to May 2021. 100 eyes of 100 PACS were included. Anterior chamber angle (ACA), central anterior chamber depth (ACD), anterior chamber volume (ACV) and central corneal thickness (CCT) were recorded from the Pentacam before and one month after LPI. ACA was graded according to Shaffer classification using the Goldmann gonioscopy. The paired samples t-test was used to compare the difference in ASP while Wilcoxson signed-rank test was used to assess the ACA grading.
Results: Among enrolled males were 41% & mean age was 50.56 ± 6.03 SD (ranged 40 to 60 years). 27% had previous glaucoma treatment history and 88% had positive family history of glaucoma. Mild lenticular sclerosis was present in 49%. Maximum number of cases had BCVA in > 6/18 (68%). Pentacam evaluation pre-intervention found mean ACA, ACD, ACV and CCT were 26.73 ± 1.05º, 2.09 ± 0.12 mm, 78.51 ± 7.12 mm3 and 510 ± 6.5 μm, respectively. Following LPI mean ACA, ACD and ACV showed an increase of 1.47±0.72º, 0.08±0.07 mm, and 51.08±20.56 mm3, respectively. Statistically, these changes were significant (p<0.001) except for central corneal thickness (p=0.454). Gonioscopic evaluation pre and post-LPI reveal that the angle width increased significantly in all quadrants (P<0.001) except inferior quadrant (P=0.025).
Conclusion: Both Gonioscopy and Pentacam can easily access efficacy of LPI. Pentacam is more sensitive to minor changes.
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