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Jayant Venkatramani Iyer, Ilyana Ibrahim, Sieh Yean Kiew, Monisha Esther Nongpiur, Tin Aung; 5-Year progression of primary angle closure after treatment: the Primary Angle Closure Study (PACeS). Invest. Ophthalmol. Vis. Sci. 2022;63(7):3689 – A0374.
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There is no recent evidence on progression rates of Primary Angle Closure (PAC) to Primary Angle Closure Glaucoma (PACG). We aimed to study the 5-year progression rates of treated PAC to PACG or acute primary angle closure (APAC).
A retrospective cohort study of 79 PAC subjects was performed. PAC was defined as iridotrabecular contact of 180 degrees or more, in the presence of raised intraocular pressure or peripheral anterior synechiae, without evidence of glaucomatous optic neuropathy. Data on intraocular pressure (IOP), gonioscopy, treatment instituted and time of progression to PACG or APAC were analyzed. In subjects with bilateral PAC, one eye per subject was randomly chosen for analysis.
Of the 79 PAC subjects, 58 (73.4%) subjects were female and all subjects were of Chinese descent. All eyes were treated - 76 underwent initial laser peripheral iridotomy (LPI) and 3 underwent lens extraction as a primary procedure. During the follow-up period, 30 were started on IOP-lowering medications, and another 21 underwent cataract extraction. 14 of the eyes that underwent cataract extraction required medications. None of the eyes developed APAC. Only 4 eyes progressed to PACG over 5 years of follow-up, 3 of which remained phakic at time of progression.
These results suggest that the risk of progression of treated PAC to PACG is low. Our findings reveal lower rates of 5-year progression compared to previously published data. We found that cataract extraction reduces the likelihood of requiring glaucoma medications at 5 years.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.
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