Abstract
Purpose
This study aimed to investigate the relationship between corneal decompensation following laser peripheral iridotomy (LPI) and iridocorneal endothelial contact.
Study design
Retrospective observational case series.
Methods
Specular microscopy images of LPI recipients with narrow angles were taken at the central cornea and the 8 midperipheral corneal regions at approximately 3 mm from the center. Eleven eyes of 11 patients had a minimum of ≤ 1600 cells/mm2 among 8 midperipheral corneal endothelial cell densities (ECDs). Radial scans of the angles in the 8 directions were taken with ultrasound biomicroscopy (UBM) in the supine and face-down positions. The minimum and maximum angle opening distance at 750 μm from the scleral spur of the 8 directions were defined as the narrowest and widest angles, respectively. The ECD of the narrowest angle direction was compared with the ECD of the widest angle direction.
Results
When UBM was performed with the subject in the supine position, the iris and cornea at the narrowest angle were in contact in only 4 of 11 eyes, while in the face-down position, the iris and the cornea at the narrowest angle were in contact in 10 of the 11 eyes. In the face-down UBM, the midperipheral ECD of the narrowest angle direction was significantly smaller than the midperipheral ECD of the widest angle direction (P = 0.006).
Conclusion
The ECD of the narrow angle direction can decrease after LPI. This suggests that corneal endothelial cell damage following LPI may be due to mechanical damage from iridocorneal endothelial contact.
Similar content being viewed by others
References
Quigley HA, Broman AT. The number of people with glaucoma worldwide in 2010 and 2020. Br J Ophthalmol. 2006;90:262–7.
Tham YC, Li X, Wong TY, Quigley HA, Aung T, Cheng C-Y. Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology. 2014;121:2081–90.
Radhakrishnan S, Chen PP, Junk AK, Nouri-Mahdavi K, Chen TC. Laser peripheral iridotomy in primary angle closure: a report by the American Academy of Ophthalmology. Ophthalmology. 2018;125:1110–20.
Pollack IP. Current concepts in laser iridotomy. Int Ophthalmol Clin. 1984;24:153–80.
Schwartz AL, Martin NF, Weber PA. Corneal decompensation after argon laser iridectomy. Arch Ophthalmol. 1988;106:1572–4.
Zabel RW, MacDonald IM, Mintsioulis G. Corneal endothelial decompensation after argon laser iridotomy. Can J Ophthalmol. 1991;26:367–73.
Jeng S, Lee JS, Huang SC. Corneal decompensation after argon laser iridectomy—a delayed complication. Ophthalmic Surg. 1991;22:565–9.
Wilhelmus KR. Corneal edema following argon laser iridotomy. Ophthalmic Surg. 1992;23:533–7.
Lim LS, Ho CL, Ang LPK, Aung T, Tan DTH. Inferior corneal decompensation following laser peripheral iridotomy in the superior Iris. Am J Ophthalmol. 2006;142:166–8.
Shimazaki J, Amano S, Uno T, Maeda N, Yokoi N, Japan Bullous Keratopathy Study Group (2007) National survey on bullous keratopathy in Japan. Cornea 26:274–8
Ang LPK, Higashihara H, Sotozono C, Shanmuganathan VA, Dua H, Tan DTH, et al. Argon laser iridotomy-induced bullous keratopathy a growing problem in Japan. Br J Ophthalmol. 2007;91:1613–5.
Shimazaki J, Uchino Y, Tsubota K. Late irreversible corneal oedema after laser iridotomy. Br J Ophthalmol. 2009;93:125–6.
Hayashi K, Hayashi H, Nakao F, Hayashi F. Risk factors for corneal endothelial injury during phacoemulsification. J Cataract Refract Surg. 1996;22:1079–84.
Fiore PM, Richter CU, Arzeno G, Arrigg CA, Shingleton BJ, Bellows AR, et al. The effect of anterior chamber depth on endothelial cell count after filtration surgery. Arch Ophthalmol. 1989;107:1609–11.
Gazzard G, Friedman DS, Devereux JG, Chew P, Seah SK, et al. A prospective ultrasound biomicroscopy evaluation of changes in anterior segment morphology after laser iridotomy in Asian eyes. Ophthalmology. 2007;110:630–8.
He M, Friedman DS, Ge J, Huang W, Jin C, Cai X, et al. Laser peripheral iridotomy in eyes with narrow drainage angles: ultrasound biomicroscopy outcomes. The Liwan eye study. Ophthalmology. 2007;114:1513–9.
Cheung CY, Zheng C, Ho CL, Tun TA, Kumar RS, El Sayyad F, et al. Novel anterior-chamber angle measurements by high-definition optical coherence tomography using the Schwalbe line as the landmark. Br J Ophthalmol. 2011;95:955–9.
Nonaka A, Kondo T, Kikuchi M, Yamashiro K, Fujihara M, Iwawaki T, et al. Cataract surgery for residual angle closure after peripheral laser iridotomy. Ophthalmology. 2005;112:974–9.
Imai K, Sawada H, Fukuchi T. Prone position ultrasound biomicroscopy for two plateau iris configuration cases with decreased corneal endothelial cells after laser iridotomy. J Jpn Ophthalmol Soc. 2015;119:68–76 ((in Japanese)).
Esaki K, Ishikawa H, Liebmann JM, Ritch R. A technique for performing ultrasound biomicroscopy in the sitting and prone positions. Ophthalmic Surg Lasers. 2000;31:166–9.
Amann J, Holley GP, Lee SB, Edelhauser HF. Increased endothelial cell density in the paracentral and peripheral regions of the human cornea. Am J Ophthalmol. 2003;135:584–90.
Sano R, Kurokawa T, Kurimoto Y, Miyazawa D, Yoshimura N. Comparison between the anterior chamber configuration in the supine position and that in the prone position in patients with narrow angle. J Jpn Ophthalmol Soc. 2001;105:388–93 ((in Japanese)).
Kumar RS, Baskaran M, Friedman DS, Xu Y, Wong H-TT, Lavanya R, et al. Effect of prophylactic laser iridotomy on corneal endothelial cell density over 3 years in primary angle closure suspects. Br J Ophthalmol. 2013;97:258–61.
Sihota R, Agarwal E, James M, Verma M, Kumar L, Dada T, et al. Long-term evaluation of specular microscopic changes following Nd:YAG iridotomy in chronic primary angle-closure glaucoma eyes. J Glaucoma. 2017;26:762–6.
Matsuda M, Sawa M, Edelhauser HF, Bartels SP, Neufeld AH, Kenyon KR. Cellular migration and morphology in corneal endothelial wound repair. Investig Ophthalmol Vis Sci. 1985;26:443–9.
Robin AL, Pollack IP. A comparison of neodymium: YAG and argon laser iridotomies. Ophthalmology. 1984;91:1011–6.
Lim L, Seah SK, Lim AS. Comparison of argon laser iridotomy and sequential argon laser and Nd:YAG laser iridotomy in dark irides. Ophthalmic Surg Lasers. 1996;27:285–8.
Hong C, Kitazawa Y, Tanishima T. Influence of argon laser treatment of glaucoma on corneal endothelium. Jpn J Ophthalmol. 1983;27:567–74.
Wu SC, Jeng S, Huang SC, Lin SM. Corneal endothelial damage after neodymium:YAG laser iridotomy. Ophthalmic Surg Lasers. 2000;31:411–6.
Park HYL, Lee NY, Park CK, Kim MS. Long-term changes in endothelial cell counts after early phacoemulsification versus laser peripheral iridotomy using sequential argon:YAG laser technique in acute primary angle closure. Graefe’s Arch Clin Exp Ophthalmol. 2012;250:1673–80.
Sung KR, Lee KS, Hong JW. Baseline anterior segment parameters associated with the long-term outcome of laser peripheral iridotomy. Curr Eye Res. 2015;40:1128–33.
Higashihara H, Sotozono C, Yokoi N, Inatomi T, Kinoshita S. The blood-aqueous barrier breakdown in eyes with endothelial decompensation after argon laser iridotomy. Br J Ophthalmol. 2011;95:1032–4.
Yamagami S, Yokoo S, Suzuki M, Usui TAS. Mechanism of bullous keratopathy development after laser iridotomy: macrophage theory. J Eye. 2007;18:885–90 ((in Japanese)).
Kaji Y, Oshika T, Usui T, Sakakibara J. Effect of shear stress on attachment of corneal endothelial cells in association with corneal endothelial cell loss after laser iridotomy. Cornea. 2005;24:S55–8.
Yamamoto Y, Uno T, Joko T, Shiraishi A, Ohashi Y. Effect of anterior chamber depth on shear stress exerted on corneal endothelial cells by altered aqueous flow after laser iridotomy. Investig Ophthalmol Vis Sci. 2010;51:1956–64.
Jiang Y, Chang DS, Zhu H, Khawaja AP, Aung T, Huang S, et al. Longitudinal changes of angle configuration in primary angle-closure suspects: the Zhongshan angle-closure prevention trial. Ophthalmology. 2014;121:1699–705.
Peng PH, Nguyen H, Lin HS, Nguyen N, Lin S. Long-term outcomes of laser iridotomy in Vietnamese patients with primary angle closure. Br J Ophthalmol. 2011;95:1207–11.
Kumar RS, Baskaran M, Chew PTK, Friedman DS, Handa S, Lavanya R, et al. Prevalence of Plateau Iris in primary angle closure suspects. An ultrasound biomicroscopy study. Ophthalmology. 2008;115:430–4.
Acknowledgements
We would like to thank Editage (www.editage.jp) for English language editing and Mr. Steven Yoell for his English language advice.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflicts of interest
K. Imai, None; H. Sawada, None; T. Hatase, None; T. Fukuchi, Grant (Alcon, HOYA), Grant, Lecture fee (Abbott, Otsuka, Senju, Santen), Lecture fee (Pfizer, AbbVie, NIDEK, Novartis, Glaukos, Alcon).
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Corresponding Author: Kazuyuki Imai
About this article
Cite this article
Imai, K., Sawada, H., Hatase, T. et al. Iridocorneal contact as a potential cause of corneal decompensation following laser peripheral iridotomy. Jpn J Ophthalmol 65, 460–471 (2021). https://doi.org/10.1007/s10384-021-00830-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10384-021-00830-y