Delhi Journal of Ophthalmology

Pentacam Based Quantification of the Changes in Anterior Chamber Morphology Following Laser Peripheral Iridotomy in Primary Angle Closure Suspects – A Novel Approach

Akhil Bevara, Shashidhar Banigallapati, Malleswari Medikonda, Sudhakar Potti
Sankara Eye Hospital, Guntur, Andhra Pradesh, India

Editor-in-Chief, Delhi Journal of Ophthalmology, Dr R.P.Centre, AIIMS.


Corresponding Author:

Akhil Bevara (MBBS, DNB Ophthal)
Sankara Eye Hospital, Guntur - Vijayawada Expressway, Pedakakani, Guntur, Andhra Pradesh - 522509, India
Email id: bevaraakhil@gmail.com


Received: 29-AUG-2019 Accepted: 11-SEP-2019 Published Online: 09-MAY-2020
DOI: https://dx.doi.org/10.7869/djo.527

Abstract
Aim: To study and compare the clinical parameters pre and post Nd: YAG Laser Peripheral Iridotomy (LPI) in Primary Angle Closure Suspect (PACS) patients.
Study design: Hospital based prospective observational study.
Methods: Our study included 60 eyes of 30 PACS patients who underwent Nd: YAG LPI. Parameters like anterior chamber depth and angle using Pentacam, Intraocular pressure using Goldmann Applanation tonometer and Gonioscopy using Sussman 4-mirror goniolens were compared before and after LPI. 
Results: The mean ACD significantly improved from 1.91 ± 0.2 mm before LPI to 2.01 ± 0.23mm, 30 minutes post LPI and 2.06 ± 0.22 mm, one week after LPI. The mean ACA significantly improved from 24.4 ± 4.02° before LPI to 27.55 ± 3.74°, 30 minutes after LPI and 28.77 ± 4.09°, one week after LPI. There was a statistically significant decrease in mean IOP at 30 minutes and one week after LPI as compared to before LPI. Twenty-two (36.67%) eyes had IOP spike at five minutes after LPI (Mean IOP spike was 2.64 ± 0.95mm Hg). The mean Shaffer grade, based on gonioscopy findings, also increased significantly after LPI.
Conclusions: We conclude that Pentacam is a useful tool for quantifying the anterior segment changes occurring after LPI. The ACD and ACA increase significantly after LPI. Also, the IOP decreases significantly one week after LPI in PACS patients.

Keywords :Primary Angle Closure Suspects, Laser Peripheral Iridotomy, Nd: YAG, Intraocular pressure, Pentacam, Anterior chamber depth, Anterior chamber angle