Causes of Shallow Anterior Chamber in Primary Angle-Closure Glaucoma

Purpose. To evaluate the effect of phacoemulsification and intraocular lens (IOLs) implantation in eyes with medically uncontrolled primary angle-closure glaucoma (PACG) previously treated with trabeculectomy and to quantify the anatomical changes in the anterior chamber angle by ultrasound biomicroscopy (UBM). Methods. Forty-four eyes of 37 consecutive patients with medically uncontrolled PACG coexisting cataracts with a surgical history of trabeculectomy were included in this study. Each patient underwent phacoemulsification and IOL implantation. Indentation gonioscopy and UBM were performed preoperatively and then again 3 months after surgery. The main outcome measures were best-corrected visual acuity (BCVA), intraocular pressure (IOP), number of antiglaucoma medications and anatomical changes in the anterior chamber angle. Results. The mean logarithm of the minimum angle of resolution BCVA significantly improved from 0.52 ± 0.30 preoperatively to 0.26 ± 0.23 postoperatively (p<0.001). The mean IOP significantly decreased from 24.33 ± 9.65 mmHg preoperatively to 18.04 ± 7.86 mmHg postoperatively (p<0.05). 001). The median number of antiglaucoma medications decreased from 2 preoperatively to 1 postoperatively (p<0.001). There was no significant difference in the extent of peripheral anterior synechia after the surgery (p>0.05). Some parameters, including anterior central chamber depth, angle opening distance at 500 μm, trabecular-iris angle, and scleral ciliary process angle, were significantly higher after than before surgery (p<0.001). However, the crystalline lens rise was significantly smaller following the surgery (p<0.001). Conclusions. Phacoemulsification and IOL implantation reduced the IOP and improved vision in eyes with medically uncontrolled filtered PACG. The mechanism underlying the outcomes observed following surgery might be related to the anterior chamber deepening, widened drainage angle, and improved aqueous fluid flow to the trabecular meshwork.

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Efficacy and safety of immediate anterior chamber paracentesis in the treatment of acute primary angle-closure glaucoma

Ophthalmology ◽

10.1016/s0161-6420(01)00857-0 ◽

2002 ◽

Vol 109 (1) ◽

pp. 64-70 ◽

Cited By ~ 56

Author(s):

Dennis S.C Lam ◽

John K.H Chua ◽

Clement C.Y Tham ◽

Jimmy S.M Lai

Keyword(s):

Anterior Chamber ◽

Angle Closure Glaucoma ◽

Angle Closure ◽

Efficacy And Safety ◽

Acute Primary Angle Closure ◽

Primary Angle Closure ◽

Primary Angle Closure Glaucoma ◽

Anterior Chamber Paracentesis

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Correction: ABCC5, a Gene That Influences the Anterior Chamber Depth, Is Associated with Primary Angle Closure Glaucoma

PLoS Genetics ◽

10.1371/journal.pgen.1004352 ◽

2014 ◽

Vol 10 (4) ◽

pp. e1004352

Author(s):

Keyword(s):

Anterior Chamber ◽

Anterior Chamber Depth ◽

Angle Closure Glaucoma ◽

Angle Closure ◽

Primary Angle Closure ◽

Primary Angle Closure Glaucoma

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Elucidation of presence of increased risk formation of primary angle-closure glaucoma among patients with hyperopia in department of refractive surgery

Modern technologies in ophtalmology ◽

10.25276/2312-4911-2021-5-162-164 ◽

2021 ◽

pp. 162-164

Author(s):

N.V. Samokhvalov ◽

◽

E.L. Sorokin ◽

A.N. Marchenko ◽

Y.E. Pashentsev ◽

...

Keyword(s):

Anterior Chamber ◽

Refractive Surgery ◽

Young Patients ◽

Anterior Chamber Depth ◽

Acute Attack ◽

Angle Closure Glaucoma ◽

Angle Closure ◽

Primary Angle Closure ◽

Primary Angle Closure Glaucoma ◽

Increased Risk

Important physiological feature of the anatomically «short» eye is the disproportionately large volume of the lens relative to the volume of the eye. A gradual and continuous increase in the volume of the lens contributes to the anterior displacement of the irido-lenticular diaphragm, causing the functional block of the anterior chamber angle. This leads to persistent disorders of the hydrodynamics of the eye, up to the development of an acute attack of angle-closure glaucoma. Purpose. To study incidence of increased risk formation of primary angle-closure glaucoma (PACG) and its acute attack in young patients with moderate and high hyperopia (Hm). Material and methods. Clinical material was presented by 58 patients (116 eyes) with indicators of axial length of the eyes less than 23 mm. The main group consisted of 33 patients (66 eyes) with moderate and high Hm. The comparison group was represented by 25 patients (50 eyes) with PACG. Results. The study made it possible to identify group of increased risk of the formation of PACG, which included 19 people (58%), from selected general population of young patients with moderate and high Hm. Conclusion. Comparative analysis of morphometric parameters of structures of the anterior segment of the anatomically «short» eyes in young patients with moderate and high Hm, on the one hand, and in patients with PACG, on the other, revealed statistically significant differences between them in the anterior chamber depth in the central zone, the thickness of the lens, the anterior chamber volume, the peripheral anterior chamber depth, of the anterior chamber angle. Key words: primary angle-closure glaucoma, acute attack of angle-closure glaucoma, hyperopia, refractive surgery.

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