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Shida Chen, Jianhua Lv, Sujie Fan, Hong Zhang, Lin Xie, Ling Xu, Bing Jiang, Huipin Yuan, Yuanbo Liang, Shuning Li, Pingyan Chen, Xiulan Zhang, Ningli Wang
BACKGROUND: China has the largest burden of primary angle-closure glaucoma (PACG) worldwide. The mechanism of the angle closure is complex and includes pupillary block and non-pupillary block. Currently, opinion is that laser peripheral iridotomy (LPI) alone is not sufficient to prevent disease progression. Laser peripheral iridoplasty (LPIP) is an alternative and effective way of widening the angle recess in eyes that are affected by primary angle closure (PAC). However, it is not known if greater benefit would be achieved using LPI plus LPIP for PAC with multiple mechanisms (MAC)...
March 17, 2017: Trials
Xinghuai Sun, Yi Dai, Yuhong Chen, Dao-Yi Yu, Stephen J Cringle, Junyi Chen, Xiangmei Kong, Xiaolei Wang, Chunhui Jiang
Primary angle-closure glaucoma (PACG) is a common cause of blindness. Angle closure is a fundamental pathologic process in PAGC. With the development of imaging devices for the anterior segment of the eye, a better understanding of the pathogenesis of angle closure has been reached. Aside from pupillary block and plateau iris, multiple-mechanisms are more common contributors for closure of the angle such as choroidal thickness and uveal expansion, which may be responsible for the presenting features of PACG...
March 2017: Progress in Retinal and Eye Research
Rupert R A Bourne, Ivailo Zhekov, Shahina Pardhan
AIMS: To evaluate temporal change in anterior chamber angle anatomy following argon laser peripheral iridoplasty (ALPI) in eyes with occludable angles postlaser peripheral iridotomy (LPI) compared with control eyes. Additionally, the effect on diurnal intraocular pressure (DIOP) fluctuation (maximum-minimum IOP) was investigated. METHODS: Twenty-two patients with bilateral primary angle closure/suspects with gonioscopically occludable anterior chamber angles following LPI were randomised to receive ALPI (n=11) or no further treatment (n=11)...
December 7, 2016: British Journal of Ophthalmology
Farihah Anwar, Angela Turalba
BACKGROUND: Glaucoma is the second leading cause of blindness in the world. Angle closure glaucoma accounts for 25% of all glaucoma, with Asia having the highest rate. Angle closure is an anatomical variation, making the Inuit, Chinese, and other Asians more susceptible. Current treatments include medical, laser, and surgical modalities. PURPOSE: To identify the current treatment protocols for primary angle closure. DISCUSSION: The current general protocol to treat angle closure is to lower the intraocular pressure with medications and perform laser iridotomy...
2017: Seminars in Ophthalmology
David A Hollander, Mark E Pennesi, Jorge A Alvarado
Plateau iris configuration describes an anatomic abnormality in which large or anteriorly positioned pars plicata push the iris root forward, thereby narrowing the anterior chamber angle. Plateau iris syndrome (PIS) is diagnosed if the angle remains occludable, either spontaneously or pharmacologically, after iridotomy. PIS has traditionally been treated with chronic pilocarpine or laser peripheral iridoplasty. A series of 9 eyes of 6 patients with PIS, diagnosed by dark room provocative testing and ultrasound biomicroscopy (UBM) following iridotomy, underwent cataract extraction and endoscopic cyclophotocoagulation (ECP)...
July 28, 2016: Experimental Eye Research
Bonnie Nga Kwan Choy, Jonathan Cheuk Hung Chan, Carol Pui Yang Chien, Jimmy Shiu Ming Lai
BACKGROUND: We describe two cases of recurrent acute angle-closure attack in patients with plateau iris syndrome after cataract extraction. Argon laser peripheral iridoplasty and cataract extraction have been used to reduce the occurrence of acute angle-closure attack in plateau iris syndrome although the risk cannot be completely eliminated. There is no consensus on the long term management of plateau iris syndrome. This is, as far as we know, the first case report of recurrent acute angle-closure attack in plateau iris syndrome after cataract extraction...
May 26, 2016: BMC Ophthalmology
Jimmy Lai, Bonnie N K Choy, Jennifer W H Shum
Primary angle-closure glaucoma (PACG) is a progressive optic nerve degeneration and is defined as a glaucomatous optic neuropathy with associated characteristic enlargement of optic disc cupping and visual field loss that is secondary to ocular hypertension caused by closure of the drainage angle. Angle closure is caused by appositional approximation or adhesion between the iris and the trabecular meshwork. The main treatment strategy for PACG lies in the reduction of intraocular pressure, reopening of the closed angle, and possible prevention of further angle closure...
January 2016: Asia-Pacific Journal of Ophthalmology
Federico Di Matteo, Paolo Bettin, Marina Fiori, Carlo Ciampi, Alessandro Rabiolo, Francesco Bandello
PURPOSE: To report on the safety and efficacy of Nd: YAG laser goniopuncture (LGP) for postsurgical intraocular pressure increase after deep sclerectomy (DS) in a consecutive cohort of open-angle glaucoma patients. METHODS: This case series included 56 eyes from 49 consecutive patients who underwent LGP between November 2008 and March 2015. Prior to LGP, patients had undergone DS augmented with mitomycin C and injectable cross-linked hyaluronic acid implant between October 2008 and May 2014...
March 2016: Graefe's Archive for Clinical and Experimental Ophthalmology
Arun Narayanaswamy, Mani Baskaran, Shamira A Perera, Monisha E Nongpiur, Hla M Htoon, Tin A Tun, Tina T Wong, David Goh, Daniel H Su, Paul T K Chew, Ching-Lin Ho, Tin Aung
PURPOSE: To determine the effectiveness of argon laser peripheral iridoplasty (ALPI) in primary angle closure (PAC) and primary angle-closure glaucoma (PACG). DESIGN: Randomized controlled trial. PARTICIPANTS: Eighty PAC or PACG subjects who underwent laser iridotomy (LI) and had at least 180° of persistent appositional angle closure and intraocular pressure (IOP) of more than 21 mmHg were enrolled. METHODS: Subjects were randomized to receive either 360° ALPI (Visulas 532s; Carl Zeiss Meditec, Jena, Germany) or medical therapy (Travoprost 0...
March 2016: Ophthalmology
Rengappa Ramakrishnan, Arijit Mitra, Mohideen Abdul Kader, Sasmita Das
PURPOSE: To use anterior-segment optical coherence tomography (AS-OCT) as a tool to monitor the outcome of iridoplasty in patients with primary angle closure (PAC) and plateau iris syndrome (PIS), who were unresponsive to a previous laser peripheral iridotomy. MATERIALS AND METHODS: This was a prospective, observational case control study. Patients diagnosed with PAC and PIS who had undergone laser peripheral iridotomy earlier, but were unresponsive to the procedure, were subjected to an iridoplasty...
May 2016: Journal of Glaucoma
Chelvin C A Sng, Maria Cecilia D Aquino, Jiemin Liao, Ce Zheng, Marcus Ang, Paul T K Chew
PURPOSE: To compare the effect of argon laser peripheral iridoplasty (ALPI) and conventional medical therapy in the immediate treatment of acute primary angle closure (APAC) using anterior segment optical coherence tomography (ASOCT). METHODS: In this single tertiary centre, prospective comparative study, we randomised 30 consecutive patients with unilateral APAC into two groups: ALPI and medical treatment (n=15 each). Immediately before and 1 h after either intervention, ASOCT imaging was performed...
April 2016: British Journal of Ophthalmology
Carrie Wright, Mohammed A Tawfik, Michael Waisbourd, Leslie J Katz
Primary angle-closure glaucoma is potentially a devastating disease, responsible for half of glaucoma-related blindness worldwide. Angle closure is characterized by appositional approximation or contact between the iris and trabecular meshwork. It tends to develop in eyes with shallow anterior chambers, anteriorly positioned or pushed lenses, and angle crowding. Risk of primary angle-closure glaucoma is high among women, the elderly and the hyperopic, and it is most prevalent in Asia. Investigation into genetic mechanisms of glaucoma inheritance is underway...
May 2016: Acta Ophthalmologica
Ping Huang, Ling-Ling Wu
AIM: To investigate the efficacy and safety of krypton laser peripheral iridoplasty (LPIP) for Chinese patients with primary angle closure (PAC) or primary angle-closure glaucoma (PACG) status post laser iridotomy in reversing the positive results of the dark room provocative test (DRPT). METHODS: This study was prospective, noncomparative, interventional case series. Thirty-three patients (thirty-eight eyes) with PAC or PACG status post patent laser iridotomy and maintained normal intraocular pressure (IOP) but with positive DRPT results were enrolled...
2015: International Journal of Ophthalmology
J Vila-Arteaga, R A Díaz-Céspedes, M M Suriano
CASE REPORT: We present a case of plateau iris and glaucoma due to multiple unilateral iridociliary cysts. The patient was treated with iridotomy Nd: YAG laser and 360° iridoplasty, without achieving pressure control. Phacoemulsification improved the hypertension. Dynamic gonioscopy and OCT of the anterior chamber was also performed before and after treatment. DISCUSSION: Iridociliary cysts are a benign condition that can cause iris plateau configuration, and can produce a difficult to treat ocular hypertension...
November 2015: Archivos de la Sociedad Española de Oftalmología
Brian A Francis, Andrew Pouw, Dennis Jenkins, Kelly Babic, Ghazal Vakili, James Tan, Vikas Chopra, Ronald L Green
PURPOSE: To describe the anatomic and clinical results of the treatment of severe plateau iris syndrome with lens extraction and endoscopic cycloplasty (ECPL). A secondary aim was to describe 4 novel ultrasound biomicroscopy (UBM) measurements for plateau iris syndrome. DESIGN: Prospective case series with UBM evaluation. METHODS: Included were 12 eyes of 6 patients with plateau iris refractory to laser iridotomy and iridoplasty, miotic and other glaucoma medical treatment, with appositional angle closure in at least 3 quadrants...
March 2016: Journal of Glaucoma
Daniela L M Junqueira, Vitor G Prado, Flavio S Lopes, Luis Gustavo Biteli, Syril Dorairaj, Tiago S Prata
PURPOSE: To assess the prevalence and treatment outcomes of angle-closure mechanisms other than pupillary block in a population of Brazilian patients. METHODS: A retrospective chart review was conducted to evaluate patients who had undergone laser peripheral iridotomy (LPI) due to occludable angles at a single institution between July 2009 and April 2012. An occludable angle was defined as an eye in which the posterior trabecular meshwork was not visible for ≥180° on dark-room gonioscopy...
November 2014: Arquivos Brasileiros de Oftalmologia
Soosan Jacob, Amar Agarwal, Dhivya Ashok Kumar, Ashvin Agarwal, Athiya Agarwal, Kaladevi Satish
PURPOSE: To describe changes in the surgical technique required for combining Descemet membrane endothelial keratoplasty with glued intrascleral haptic fixation of a posterior chamber intraocular lens ([IOL] glued IOL) as a single-stage surgery in patients diagnosed as having aphakic or pseudophakic bullous keratopathy. METHODS: Six patients with corneal decompensation and inadequate capsular support requiring implantation/exchange of an IOL underwent a single staged glued IOL with Descemet membrane endothelial keratoplasty at a tertiary care center...
July 2014: Journal of Refractive Surgery
F Thommen, F Gallaire, D Psaltis, T J Wolfensberger
No abstract text is available yet for this article.
April 2014: Klinische Monatsblätter Für Augenheilkunde
Konrad R Koch, Ludwig M Heindl, Claus Cursiefen, Hans-Reinhard Koch
PURPOSE: To discuss limitations and benefits of a custom-made foldable artificial iris (Artificialiris) in the management of acquired iris defects. SETTING: Hochkreuzklinik Eye Hospital, Bonn, and the Department of Ophthalmology, University of Cologne, Germany. DESIGN: Case series. METHODS: We reviewed the clinical course and surgical management in eyes with sight-compromising complications after phakic anterior chamber implantation of synthetic iris devices between November 2011 and January 2012...
March 2014: Journal of Cataract and Refractive Surgery
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