Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina, Hospital São Paulo, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Arq Bras Oftalmol. 2023 Apr 17;87(5):e20220063. doi: 10.5935/0004-2749.2022-0063. eCollection 2023.
This study aimed to compare an teriorchamber parameters acquired by a swept-source anteriorsegment optical coherence tomography before and after laser peripheral iridotomy.
This study prospectively evaluated 14 patients with primary-angle closure and six patients with primary-angle closure glaucoma. Gonioscopy and anterior-segment optical coherence tomography using the DRI OCT Triton® were performed before and after laser peripheral iridotomy. Anterior-segment optical coherence tomography parameters were studied using scleral spur as reference: angle opening distance at 250, 500, and 750 µm, trabecular-iris space at 500 µm, trabecular-iris angle, trabecular-iris contact length, and iris curvature.
Anterior-segment optical coherence tomography identified 61% of the patients with two or more quadrants closed. Gonioscopy identified more closed angles than anterior-segment optical coherence tomography before laser peripheral iridotomy. In angle parameters, only the angle opening distance of 250 µm at the nasal quadrant was not significantly increased after laser peripheral iridotomy. The iris curvature and trabecular-iris contact length showed a significant reduction induced by the laser procedure. Even in eyes in which gonioscopy did not identify angular widening after laser peripheral iridotomy (n=7), the angle opening distance of 750 µm increased (nasal, 0.15 ± 0.10 mm to 0.27 ± 0.16 mm, p=0.01; temporal, 0.14 ± 0.11 mm to 0.25 ± 0.12 mm, p=0.001) and the iris curvature decreased (nasal, 0.25 ± 0.04 mm vs. 0.11 ± 0.07 mm, p=0.02; temporal, 0.25 ± 0.07 mm vs. 0.14 ± 0.08 mm, p=0.007).
Anterior-chamber changes induced by laser peripheral iridotomy could be quantitatively evaluated and documented by DRI OCT Triton®.
本研究旨在比较激光周边虹膜切开术前后使用扫频源眼前节光学相干断层扫描（SS-OCT）获得的前房参数。
本前瞻性研究纳入了 14 例原发性闭角型青光眼患者和 6 例原发性闭角型青光眼患者。在激光周边虹膜切开术前和术后，使用 DRI OCT Triton®进行房角镜检查和眼前节 OCT。以巩膜突为参照，研究眼前节 OCT 参数：250、500 和 750μm 的房角开放距离（AOD）、500μm 的小梁虹膜空间（TIS）、小梁虹膜角（TIA）、小梁虹膜接触长度和虹膜曲率。
眼前节 OCT 识别出 61%的患者有两个或更多象限的房角关闭。激光周边虹膜切开术前，房角镜检查发现的闭角比眼前节 OCT 多。在角度参数方面，只有鼻侧象限的 250μm 的 AOD 在激光周边虹膜切开术后没有明显增加。激光手术导致虹膜曲率和小梁虹膜接触长度显著减小。即使在激光周边虹膜切开术后房角镜检查未发现角度增宽的 7 只眼中（n=7），750μm 的 AOD 也增加（鼻侧，0.15±0.10mm 至 0.27±0.16mm，p=0.01；颞侧，0.14±0.11mm 至 0.25±0.12mm，p=0.001），虹膜曲率减小（鼻侧，0.25±0.04mm 至 0.11±0.07mm，p=0.02；颞侧，0.25±0.07mm 至 0.14±0.08mm，p=0.007）。
激光周边虹膜切开术引起的前房变化可以通过 DRI OCT Triton®进行定量评估和记录。
