DR. SAKSHI RAMNANI

DR. PREMNATH RAMAN, DR.MEGHANA R HIREMATH, DR. M.N. MANGALA, DR. POOJA CHABBI

Abstract

Prospective interventional study of anterior chamber angle (AC) morphology with AS-OCT following laser peripheral iridotomy (LPI) in 64 primary angle-closure suspect (PACS) eyes to look for pre-existing relative pupillary block

Post LPI mean increase in angle in all quadrants was 13.3° (p=0.0001). Angle opening distance & trabecular-iris space area showed significant increase. The AC depth increased (2.12mm to 2.26mm) with reduction in the lens vault (722 to 693μ)

LPI causes significant widening of AC angle in PACS eyes. PACS is defined as non-visibility of posterior trabecular meshwork (TM), hence we propose to subdivide Modified Shaffer’s grade 2 into 2A as visibility of anterior TM and 2B as visibility of anterior & posterior TM to help identify PACS eyes. A positive correlation (R2=0.1) between pre-LPI lens vault and angle opening post LPI (p=0.016) was seen suggesting subclinical pupillary block leading to aqueous misdirection in PACS eyes before the onset of precipitating factor