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Wakako Ikegawa, Takashi Suzuki, Shiro Mizoue, Yuichi Ohashi; Changes in anterior segment morphology of iris bombé before and after laser peripheral iridotomy in patients with uveitic secondary glaucoma. Invest. Ophthalmol. Vis. Sci. 2014;55(13):925.
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© ARVO (1962-2015); The Authors (2016-present)
Iris bombé and acute pupillary block glaucoma are severe complications of uveitis, and little is known about anterior segment (AS) morphology in angle acute closure of iris bombé. The aim of this work was to quantify changes in AS parameters after laser peripheral iridotomy (LPI) using AS optical coherence tomography (OCT) in iris bombé.
Seven patients with iris bombé caused by anterior uveitis were enrolled, and AS images were captured at pre-LPI and more than 2weeks after LPI (post-LPI) using AS OCT (Tomey, Casia). Six of Seven patients were imaged before iris bombé. Anterior chamber depth (ACD), anterior chamber volume (ACV), iris volume (IV), iris curvature (IC), iris thickness at 500 μm from the scleral spur (IT-1),in the middle between scleral spar and pupillary margin (IT-2) and 500 μm from pupillary margin (IT-3), and Anterior chamber angle (ACA) parameters [angle opening distance (AOD750) and trabecular iris space area (TISA750)] were analyzed.
Since one patient had bilateral iris bombé, eight eyes in seven patients were investigated. Mean ACD (2.17 vs. 2.52mm), ACV (59.66 vs. 126.46 mm3), ACA parameters (AOD750 [0.10 vs. 0.69 mm] and TISA750 [0.072 vs. 0.33 mm2] at pre-LPI increased at post-LPI (ACD: P < 0.05; TISA750: P<0.01; ACV and AOD750: P<0.001). Mean IT-1 (0.25 vs. 0.37 mm) and IT-2 (0.32 vs. 0.39 mm) but not IT-3 (0.29 vs. 0.27 mm) increased at post-LPI (IT-1: P<0.01; IT-2: P<0.05; IT-3: P=0.63). IC (0.72 vs. 0.18 mm) decreased at post-LPI (P<0.001) and IV (27.34 vs. 35.44 mm3) did not changed at post-LPI. Mean IT-1 (0.25 vs. 0.39mm) but not IT-2 (0.32 vs. 0.37mm) and IT-3 (0.29 vs. 0.32mm) were lower than that before iris bombé (IT-1: P<0.001; IT-2: P=0.14; IT-3: P=0.34). There was no significant difference between ACD at pre-LPI and before iris bombé (2.17 vs. 2.37mm, P=0.20).
The iris root could be extended and become thinner in iris bombé. LPI in iris bombé could increase ACD, ACV, and ACA parameters.
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