Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, China.
Department of Ophthalmology & Visual Science, Shanghai Medical College, Fudan University, Shanghai, China.
Eye (Lond). 2023 Sep;37(13):2744-2752. doi: 10.1038/s41433-023-02408-z. Epub 2023 Jan 27.
To evaluate the effect of miosis and laser peripheral iridotomy (LPI) on intraocular lens (IOL) power prediction and ocular biometry in eyes with primary angle closure disease (PACD).
In this prospective observational study, primary angle closure suspects (PACS), and subjects classified with primary angle closure (PAC)/primary angle-closure glaucoma (PACG) undergoing LPI were enrolled. Ocular biometric parameters were measured with IOLMaster700 at baseline (T), one week after pilocarpine instillation (T), and another week post LPI (T). Biometric changes and the IOL power predicted for emmetropia using Barrett Universal II, Haigis, Holladay2, Hoffer Q and SRK/T formulae were analysed and compared among different time points.
100 eyes of 50 PACS and 50 PAC/PACG patients were enrolled. Following pilocarpine-induced miosis, lens thickness (LT) increased and anterior chamber depth (ACD) decreased (all groups p < 0.01), while white-to-white diameter decreased and central corneal thickness increased significantly only in the PACS cohort (both p < 0.01). Compared to baseline, LPI induced an increase of ACD and a slight decrease of LT in PACS (both p < 0.01), whereas only axial length changed significantly (p = 0.012) in the PAC/PACG cohort. Regardless of the formula used, no significant difference to the predicted IOL power for emmetropia existed among the three time points in each group (all p > 0.1).
We report the changes of anterior segment parameters induced by miosis and LPI in PACD. These interventions do not significantly affect the IOL power calculation predicted for emmetropia in Chinese eyes when common third-, fourth-and new generation IOL formulae are used.
评估瞳孔缩小和激光周边虹膜切开术（LPI）对原发性闭角型青光眼（PACD）患者人工晶状体（IOL）屈光力预测和眼生物测量的影响。
本前瞻性观察性研究纳入了原发性房角关闭可疑患者（PACS）和接受 LPI 的原发性房角关闭（PAC）/原发性房角关闭性青光眼（PACG）患者。在基线（T）、毛果芸香碱滴眼后一周（T）和 LPI 后一周（T），使用 IOLMaster700 测量眼生物测量参数。分析并比较了不同时间点的眼生物测量变化和使用 Barrett Universal II、Haigis、Holladay2、Hoffer Q 和 SRK/T 公式预测的用于正视眼的 IOL 屈光力。
共纳入 50 例 PACS 和 50 例 PAC/PACG 患者的 100 只眼。毛果芸香碱诱导瞳孔缩小时，晶状体厚度（LT）增加，前房深度（ACD）减少（所有组均 p<0.01），而仅在 PACS 组中，瞳孔直径和中央角膜厚度显著减少（均 p<0.01）。与基线相比，LPI 引起 PACS 的 ACD 增加和 LT 轻度减少（均 p<0.01），而 PAC/PACG 组仅轴向长度发生显著变化（p=0.012）。无论使用哪种公式，每组三个时间点的预测正视眼 IOL 屈光力均无显著差异（均 p>0.1）。
我们报告了 PACD 患者瞳孔缩小时和 LPI 引起的前节参数变化。当使用常见的第三代、第四代和新一代 IOL 公式时，这些干预措施不会显著影响中国人群预测正视眼的 IOL 屈光力计算。
