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Anterior chamber paracentesis and pH values in patients with acute primary angle closure

  • Glaucoma
  • Published:
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Abstract

Background

To assess the efficacy and safety of anterior chamber paracentesis (ACP) and the changes in pH values in eyes with acute primary angle closure (APAC).

Methods

This retrospective case-control study involved 22 patients with APAC who underwent ACP (study group) and 21 patients with APAC who did not undergo ACP (control group). Intraocular pressure (IOP) and visual acuity were measured before treatment and 15 min and 24 h after treatment in both groups. The pH of aqueous humor was measured immediately after ACP in the study group.

Results

A total of 43 eyes in 43 patients were reviewed. The IOP 15 min after ACP (23.3 ± 9.6 mmHg) and 24 h after ACP (21.6 ± 12.0 mmHg) were significantly lower than that before ACP (58.6 ± 12.9 mmHg). The IOP 15 min after ACP was significantly lower than the IOP 15 min after conventional treatment (55.4 ± 10.3 mmHg). Visual acuity recovery was achieved earlier after ACP than after conventional treatment. Hyphema after ACP was noted in one eye. The mean pH of the aqueous humor in APAC was 6.99 ± 0.35. The pH of the aqueous humor significantly correlated with the duration of acute IOP elevation and the IOP before ACP.

Conclusions

ACP is an effective and safe procedure. The pH of aqueous humor is lower in eyes with APAC of longer duration and in eyes with higher IOP at presentation.

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References

  1. Quigley HA (1996) Number of people with glaucoma worldwide. Br J Ophthalmol 80:389–393

    Article  PubMed  CAS  Google Scholar 

  2. Thylefors B, Negrel AD, Pararajasegaram R, Dadzie KY (1995) Global data on blindness. Bull World Health Organ 73:115–121

    PubMed  CAS  Google Scholar 

  3. Foster PJ, Oen FT, Machin D, Ng TP, Devereux JG, Johnson GJ, Khaw PT, Seah SK (2000) The prevalence of glaucoma in Chinese residents of Singapore: a cross-sectional population survey of the Tanjong Pagar district. Arch Ophthalmol 118:1105–1111

    Article  PubMed  CAS  Google Scholar 

  4. Dandona L, Dandona R, Mandal P, Srinivas M, John RK, McCarty CA, Rao GN (2000) Angle-closure glaucoma in an urban population in southern India. The Andhra Pradesh eye disease study. Ophthalmology 107:1710–1716

    Article  PubMed  CAS  Google Scholar 

  5. Foster PJ, Johnson GJ (2001) Glaucoma in China: how big is the problem? Br J Ophthalmol 85:1277–1282

    Article  PubMed  CAS  Google Scholar 

  6. David R, Tessler Z, Yassur Y (1985) Long-term outcome of primary acute angle-closure glaucoma. Br J Ophthalmol 69:261–262

    Article  PubMed  CAS  Google Scholar 

  7. Chen YH, Lu DW, Cheng JH, Chen JT, Chen CL (2009) Trabeculectomy in patients with primary angle-closure glaucoma. J Glaucoma 18:679–683

    Article  PubMed  Google Scholar 

  8. Van der Lelij A, Rothova A (1997) Diagnostic anterior chamber paracentesis in uveitis: a safe procedure? Br J Ophthalmol 81:976–979

    Article  PubMed  Google Scholar 

  9. Carnahan MC, Platt LW (2002) Serial paracenteses in the management of acute elevations of intraocular pressure. Ophthalmology 109:1604–1606

    Article  PubMed  Google Scholar 

  10. Lam DS, Chua JK, Tham CC, Lai JS (2002) Efficacy and safety of immediate anterior chamber paracentesis in the treatment of acute primary angle-closure glaucoma: a pilot study. Ophthalmology 109:64–70

    Article  PubMed  Google Scholar 

  11. Arnavielle S, Creuzot-Garcher C, Bron AM (2007) Anterior chamber paracentesis in patients with acute elevation of intraocular pressure. Graefes Arch Clin Exp Ophthalmol 245: 345-350

    Article  PubMed  Google Scholar 

  12. Plange N, Kaup M, Huber K, Remky A, Arend O (2006) Fluorescein filling defects of the optic nerve head in normal tension glaucoma, primary open-angle glaucoma, ocular hypertension and healthy controls. Ophthalmic Physiol Opt 26:26–32

    Article  PubMed  Google Scholar 

  13. Galassi F, Nuzzaci G, Sodi A, Casi P, Vielmo A (1992) Color Doppler imaging in evaluation of optic nerve blood supply in normal and glaucomatous subjects. Int Ophthalmol 16:273–276

    Article  PubMed  CAS  Google Scholar 

  14. Harris A, Sergott RC, Spaeth GL, Katz JL, Shoemaker JA, Martin BJ (1994) Color Doppler analysis of ocular vessel blood velocity in normal-tension glaucoma. Am J Ophthalmol 118:642–649

    PubMed  CAS  Google Scholar 

  15. Michelson G, Langhans MJ, Groh MJ (1996) Perfusion of the juxtapapillary retina and the neuroretinal rim area in primary open angle glaucoma. J Glaucoma 5:91–98

    PubMed  CAS  Google Scholar 

  16. Nicolela MT, Hnik P, Drance SM (1996) Scanning laser Doppler flowmeter study of retinal and optic disk blood flow in glaucomatous patients. Am J Ophthalmol 122:775–783

    PubMed  CAS  Google Scholar 

  17. Lu DW, Chang CJ, Wu JN (2001) The changes of vitreous pH values in an acute glaucoma rabbit model. J Ocul Pharmacol Ther 17:343–350

    Article  PubMed  CAS  Google Scholar 

  18. Shaffer RN (1973) A suggested anatomic classification to define the pupillary block glaucomas. Invest Ophthalmol 12:540–542

    PubMed  CAS  Google Scholar 

  19. Helbig H, Noske W, Kleineidam M, Kellner U, Foerster MH (1995) Bacterial endophthalmitis after anterior chamber paracentesis. Br J Ophthalmol 79:866

    Article  PubMed  CAS  Google Scholar 

  20. Gupta R, Browning AC, Amoaku WM (2005) Multiple retinal haemorrhages (decompression retinopathy) following paracentesis for macular branch artery occlusion. Eye (Lond) 19:592–593

    Article  CAS  Google Scholar 

  21. Tan AM, Loon SC, Chew PT (2009) Outcomes following acute primary angle closure in an Asian population. Clin Exp Ophthalmol 37:467–472

    Article  Google Scholar 

  22. Flammer J, Orgul S, Costa VP, Orzalesi N, Krieglstein GK, Serra LM, Renard JP, Stefansson E (2002) The impact of ocular blood flow in glaucoma. Progr Retin Eye Res 21:359–393

    Article  Google Scholar 

  23. Hertz L (2008) Bioenergetics of cerebral ischemia: a cellular perspective. Neuropharmacology 55:289–309

    Article  PubMed  CAS  Google Scholar 

  24. Sharma RG, Mishra YC, Verma GL, Lal K (1983) A clinical evaluation of oxygen and carbon dioxide values and pH in the human aqueous humour in normal and cataractous eyes. Indian J Ophthalmol 31:525–527

    PubMed  CAS  Google Scholar 

  25. Uhm KB, Lee JM, Sung HK (2005) Comparison of glaucomatous optic nerve damage in primary angle-closure glaucoma with and without acute attack. Kor J Ophthalmol 19:201–207

    Article  Google Scholar 

  26. Xiong ZG, Pignataro G, Li M, Chang SY, Simon RP (2008) Acid-sensing ion channels (ASICs) as pharmacological targets for neurodegenerative diseases. Curr Opin Pharmacol 8:25–32

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, No. 325, Sec. 2, Cheng-Kong Rd., Taipei, 114, Taiwan

    Da-Wen Lu, Ming-Cheng Tai, Yun-Hsiang Chang, Chang-Min Liang, Ching-Long Chen, Ke-Hung Chien, Jiann-Torng Chen & Yi-Hao Chen

  2. Graduate Institute of Medical Science, National Defense Medical Center, Taipei, Taiwan

    Da-Wen Lu, Ming-Cheng Tai, Chang-Min Liang, Ching-Long Chen, Jiann-Torng Chen & Yi-Hao Chen

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  1. Da-Wen Lu
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  2. Ming-Cheng Tai
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Correspondence to Yi-Hao Chen.

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Lu, DW., Tai, MC., Chang, YH. et al. Anterior chamber paracentesis and pH values in patients with acute primary angle closure. Graefes Arch Clin Exp Ophthalmol 251, 1229–1234 (2013). https://doi.org/10.1007/s00417-012-2198-y

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  • DOI: https://doi.org/10.1007/s00417-012-2198-y

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