Comparing the Effect of Lens Extraction With Endocycloplasty to Lens Extraction Alone in Eyes With Plateau Iris Configuration: Pilot Study

J Glaucoma. 2021 May 1;30(5):436-443. doi: 10.1097/IJG.0000000000001793.

Abstract

Precis: Lens extraction with endocycloplasty (LE/ECPL) results in greater angle deepening than LE alone in plateau iris eyes. This study directly compares an LE/ECPL treatment group with a control group.

Purpose: Quantitatively determine the effect of LE/ECPL versus LE alone for eyes with plateau iris configuration/plateau iris syndrome (PIC/PIS) on angle parameters.

Methods: Patients with PIC/PIS who underwent LE/ECPL or LE alone were reviewed. Eyes with ultrasound biomicroscopy-documented PIC that underwent anterior segment optical coherence tomography examination before and after treatment were included. Angle parameters, angle opening distance (AOD), trabecular-iris space area (TISA), and trabecular-iris circumference volume (TICV) were calculated. Angle parameters were compared between treatments using a 2-sample t test. P-values were adjusted by the false discovery rate method (P*). A paired t test was used to compare treated (nasal) and untreated (temporal) angles in LE/ECPL-treated eyes.

Results: Twenty-three eyes of 14 participants were included. Ten eyes (43%) eyes of 7 participants were treated with LE/ECPL, and 13 eyes (57%) of 7 participants were treated with LE alone. Angles were deepened in both groups (P<0.001). Changes in AOD, TISA, and TICV showed that the magnitude of deepening in treated (nasal) quadrants was greater in LE/ECPL eyes than in LE alone eyes (P<0.05). ECPL-treated angles deepened more than the untreated angles by AOD, TISA, and TICV (P<0.002).

Conclusion: Our study suggests that LE/ECPL is more effective than LE alone in opening the anterior chamber angle and that ECPL deepens treated angles more than untreated angles. This study directly compares an LE/ECPL treatment group with a control group, LE alone, allowing for separation of the effect of ECPL from LE.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anterior Chamber
  • Glaucoma, Angle-Closure*
  • Gonioscopy
  • Humans
  • Intraocular Pressure
  • Iris / diagnostic imaging
  • Iris / surgery
  • Iris Diseases* / diagnostic imaging
  • Iris Diseases* / surgery
  • Pilot Projects
  • Tomography, Optical Coherence