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Anterior segment morphology after acute primary angle closure treatment: a randomised study comparing iridoplasty and medical therapy.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Sng, Chelvin C. A. Aquino, Maria Cecilia D. Liao, Jiemin Zheng, Ce Ang, Marcus Chew, Paul T. K.
Description	Country affiliation: Singapore Author Affiliation: Sng CC ( Department of Ophthalmology, National University Health System, Singapore, Singapore Singapore Eye Research Institute and Singapore National Eye Centre, Singapore, Singapore.); Aquino MC ( Department of Ophthalmology, National University Health System, Singapore, Singapore.); Liao J ( Department of Ophthalmology, National University Health System, Singapore, Singapore.); Zheng C ( Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Kowloon, Hong Kong.); Ang M ( Singapore Eye Research Institute and Singapore National Eye Centre, Singapore, Singapore.); Chew PT ( Department of Ophthalmology, National University Health System, Singapore, Singapore Singapore Eye Research Institute and Singapore National Eye Centre, Singapore, Singapore.)
Abstract	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 1âh after either intervention, ASOCT imaging was performed. Custom software was used to measure pupil diameter, anterior chamber depth, iris curvature (I-Curv), iris area (I-Area), and the angle opening distance (AOD750), trabecular iris space area (TISA750) and the iris thickness at 750âµm from the scleral spur. The main outcome measure was the change in anterior segment biometrical parameters. RESULTS: The mean age of the patients was 62.8±7.7âyears; 13 (43.3%) were male. APAC eyes treated with ALPI had a larger increase in AOD750 (p=0.002) and TISA750 (p=0.006); a smaller increase in I-Area (p=0.004) and a decrease in I-Curv (p=0.001) after treatment compared with those eyes which received medical therapy. An optimal model consisting of age, gender, pretreatment and post-treatment pupil diameter, treatment modality and pretreatment I-Curv explained 53.2% of the variance in AOD750 change after treatment, with the treatment modality accounting for 35.0% and I-Curv accounting for 12.4% of the variability. CONCLUSIONS: We observed a greater increase in angle width after ALPI compared with after medical treatment in eyes with APAC. Treatment modality and pretreatment I-Curv were the most significant predictors of angle width change after treatment.
File Format	HTM / HTML
ISSN	00071161
Issue Number	4
Volume Number	100
e-ISSN	14682079
Journal	British Journal of Ophthalmology
Language	English
Publisher	BMJ Publishing Group Ltd.
Publisher Date	2016-04-01
Publisher Place	Great Britain (UK)
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Therapy Research Support, Non-u.s. Gov't Prospective Studies Comparative Study Humans Middle Aged Anterior Eye Segment Male Pilocarpine Glaucoma, Angle-closure Journal Article Discipline Ophthalmology Iridectomy Iris Surgery Ophthalmic Solutions Tonometry, Ocular Female Physiology Antihypertensive Agents Timolol Acute Disease Tertiary Care Centers Argon Plasma Coagulation Intraocular Pressure Tomography, Optical Coherence Drug Therapy Brimonidine Tartrate Randomized Controlled Trial Drug Effects Therapeutic Use Pathology Aged Gonioscopy
Content Type	Text
Resource Type	Article
Subject	Ophthalmology Sensory Systems Cellular and Molecular Neuroscience

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