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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

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Abstract

Objective

To compare the change in endothelial cell counts (ECC) after early phacoemulsification and laser peripheral iridotomy (LPI) using sequential argon:yttrium–aluminum–garnet (YAG) laser technique for the treatment of acute primary angle closure (APAC).

Methods

This was a retrospective chart review, case-control study; 86 APAC patients were enrolled. Sixteen patients who underwent early phacoemulsification with intraocular lens implantation and 32 patients who underwent LPI were matched by propensity score analysis. All subjects underwent a complete ophthalmic examination, including intraocular pressure (IOP) measurements, optic disc examinations, and gonioscopy. ECC were acquired at the center of the cornea with a noncontact specular microscope before treatment, and at 1, 6, 12, and 24 months following phacoemulsification or LPI.

Results

The mean follow-up was 26.1 ± 4.7 months in the phacoemulsification group and 26.3 ± 4.5 months in the LPI group. After intervention, the changes in anterior chamber depth and Shaffer grading by gonioscopy were significantly different between groups. ECC were not different before treatment; however, after phacoemulsification or LPI at 12 months (2280 ± 320 vs 1993 ± 380 cells/mm2) and 24 months (2113 ± 333 vs 1880 ± 422 cells/mm2), there was a significant difference between the two groups (P = 0.040 and P = 0.032 respectively). Regression analysis showed that anterior chamber depth at baseline (P = 0.041) and intervention modality (phacoemulsification vs LPI; P < 0.001) were significantly related to the change in ECC.

Conclusions

Early phacoemulsification showed lower endothelial cell loss than did LPI in the treatment of APAC after a 2-year follow-up. In terms of ECC, early phacoemulsification could be a better intervention modality for APAC.

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References

  1. Peng PH, Nguyen H, Lin HS, Nguyen N, Lin S (2011) Long-term outcomes of laser iridotomy in Vietnamese patients with primary angle closure. Br J Ophthalmol 95:1207–1211

    Article  PubMed  Google Scholar 

  2. Robin AL, Pollack IP (1982) Argon laser peripheral iridotomies in the treatment of primary angle closure glaucoma. Long-term follow-up. Arch Ophthalmol 100:919–923

    Article  PubMed  CAS  Google Scholar 

  3. Aung T, Ang LP, Chan SP, Chew PT (2001) Acute primary angle-closure: long-term intraocular pressure outcome in Asian eyes. Am J Ophthalmol 131:7–12

    Article  PubMed  CAS  Google Scholar 

  4. Salmon JF (1993) Long-term intraocular pressure control after Nd-YAG laser iridotomy in chronic angle-closure glaucoma. J Glaucoma 2:291–296

    PubMed  CAS  Google Scholar 

  5. Hong C, Kitazawa Y, Tanishima T (1983) Influence of argon laser treatment of glaucoma on corneal endothelium. Jpn J Ophthalmol 27:567–574

    PubMed  CAS  Google Scholar 

  6. Kataoka T, Zako M, Takeyama M, Ohno-Jinno A, Sugenoya J, Iwaki M (2007) Cooling prevents induction of corneal damage by argon laser peripheral iridotomy. Jpn J Ophthalmol 51:317–324

    Article  PubMed  Google Scholar 

  7. Jeng S, Lee JS, Huang SC (1991) Corneal decompensation after argon laser iridectomy—a delayed complication. Ophthalmic Surg 22:565–569

    PubMed  CAS  Google Scholar 

  8. Kalnins LY, Mandelkorn RM (1989) Corneal decompensation after argon laser iridectomy. Arch Ophthalmol 107:792

    Article  PubMed  CAS  Google Scholar 

  9. Schwartz AL, Martin NF, Weber PA (1988) Corneal decompensation after argon laser iridectomy. Arch Ophthalmol 106:1572–1574

    Article  PubMed  CAS  Google Scholar 

  10. Ang LP, Higashihara H, Sotozono C, Shanmuganathan VA, Dua H, Tan DT, Kinoshita S (2007) Argon laser iridotomy-induced bullous keratopathy a growing problem in Japan. Br J Ophthalmol 91:1613–1615

    Article  PubMed  Google Scholar 

  11. Shimazaki J, Amano S, Uno T, Maeda N, Yokoi N (2007) National survey on bullous keratopathy in Japan. Cornea 26:274–278

    Article  PubMed  Google Scholar 

  12. Lai JS, Tham CC, Chan JC (2006) The clinical outcomes of cataract extraction by phacoemulsification in eyes with primary angle-closure glaucoma (PACG) and co-existing cataract: a prospective case series. J Glaucoma 15:47–52

    Article  PubMed  Google Scholar 

  13. Kubota T, Toguri I, Onizuka N, Matsuura T (2003) Phacoemulsification and intraocular lens implantation for angle closure glaucoma after the relief of pupillary block. Ophthalmologica 217:325–328

    Article  PubMed  Google Scholar 

  14. Jacobi PC, Dietlein TS, Luke C, Engels B, Krieglstein GK (2002) Primary phacoemulsification and intraocular lens implantation for acute angle-closure glaucoma. Ophthalmology 109:1597–1603

    Article  PubMed  Google Scholar 

  15. Lam DS, Leung DY, Tham CC, Li FC, Kwong YY, Chiu TY, Fan DS (2008) Randomized trial of early phacoemulsification versus peripheral iridotomy to prevent intraocular pressure rise after acute primary angle closure. Ophthalmology 115:1134–1140

    Article  PubMed  Google Scholar 

  16. Su WW, Chen PY, Hsiao CH, Chen HS (2011) Primary phacoemulsification and intraocular lens implantation for acute primary angle-closure. PLoS One 6:e20056

    Article  PubMed  CAS  Google Scholar 

  17. Thomas R, Walland MJ, Parikh RS (2011) Clear lens extraction in angle closure glaucoma. Curr Opin Ophthalmol 22:110–114

    Article  PubMed  Google Scholar 

  18. Ho T, Fan R (1992) Sequential argon-YAG laser iridotomies in dark irides. Br J Ophthalmol 76:329–331

    Article  PubMed  CAS  Google Scholar 

  19. D'Agostino RB Jr (1998) Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group. Stat Med 17:2265–2281

    Article  PubMed  Google Scholar 

  20. Austin PC (2007) Propensity-score matching in the cardiovascular surgery literature from 2004 to 2006: a systematic review and suggestions for improvement. J Thorac Cardiovasc Surg 134:1128–1135

    Article  PubMed  Google Scholar 

  21. Setala K (1979) Corneal endothelial cell density after an attack of acute glaucoma. Acta Ophthalmol (Copenh) 57:1004–1013

    Article  CAS  Google Scholar 

  22. Bigar F, Witmer R (1982) Corneal endothelial changes in primary acute angle-closure glaucoma. Ophthalmology 89:596–599

    PubMed  CAS  Google Scholar 

  23. Sihota R, Lakshmaiah NC, Titiyal JS, Dada T, Agarwal HC (2003) Corneal endothelial status in the subtypes of primary angle closure glaucoma. Clin Exp Ophthalmol 31:492–495

    Article  Google Scholar 

  24. Tham CC, Kwong YY, Lai JS, Lam DS (2006) Effect of a previous acute angle closure attack on the corneal endothelial cell density in chronic angle closure glaucoma patients. J Glaucoma 15:482–485

    Article  PubMed  Google Scholar 

  25. Chen MJ, Liu CJ, Cheng CY, Lee SM (2012) Corneal status in primary angle-closure glaucoma with a history of acute attack. J Glaucoma 21(1):12–16

    Article  PubMed  Google Scholar 

  26. Lim LS, Ho CL, Ang LP, Aung T, Tan DT (2006) Inferior corneal decompensation following laser peripheral iridotomy in the superior iris. Am J Ophthalmol 142:166–168

    Article  PubMed  Google Scholar 

  27. Hata H, Yamane S, Hata S, Shiota H (2008) Preliminary outcomes of primary phacoemulsification plus intraocular lens implantation for primary angle-closure glaucoma. J Med Invest 55:287–291

    Article  PubMed  Google Scholar 

  28. Ko YC, Liu CJ, Lau LI, Wu CW, Chou JC, Hsu WM (2008) Factors related to corneal endothelial damage after phacoemulsification in eyes with occludable angles. J Cataract Refract Surg 34:46–51

    Article  PubMed  Google Scholar 

  29. Bourne RR, Minassian DC, Dart JK, Rosen P, Kaushal S, Wingate N (2004) Effect of cataract surgery on the corneal endothelium: modern phacoemulsification compared with extracapsular cataract surgery. Ophthalmology 111:679–685

    Article  PubMed  Google Scholar 

  30. Hayashi K, Hayashi H, Nakao F, Hayashi F (1996) Risk factors for corneal endothelial injury during phacoemulsification. J Cataract Refract Surg 22:1079–1084

    PubMed  CAS  Google Scholar 

  31. Malaise-Stals J, Collignon-Brach J, Weekers JF (1984) Corneal endothelial cell density in acute angle-closure glaucoma. Ophthalmologica 189:104–109

    Article  PubMed  CAS  Google Scholar 

  32. Nolan W (2006) Lens extraction in primary angle closure. Br J Ophthalmol 90:1–2

    Article  PubMed  CAS  Google Scholar 

  33. Zabel RW, MacDonald IM, Mintsioulis G (1991) Corneal endothelial decompensation after argon laser iridotomy. Can J Ophthalmol 26:367–373

    PubMed  CAS  Google Scholar 

  34. Walkow T, Anders N, Klebe S (2000) Endothelial cell loss after phacoemulsification: relation to preoperative and intraoperative parameters. J Cataract Refract Surg 26:727–732

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Ophthalmology and Visual Science, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 505 Banpo-dong, Seocho-ku, Seoul, 137-701, Korea

    Hae-Young Lopilly Park, Chan Kee Park & Man Soo Kim

  2. Department of Ophthalmology and Visual Science, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

    Na Young Lee

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  1. Hae-Young Lopilly Park
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  2. Na Young Lee
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Corresponding author

Correspondence to Man Soo Kim.

Additional information

Hae-Young Lopilly Park and Na Young Lee contributed equally to this work.

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Park, HY.L., Lee, N.Y., Park, C.K. et al. 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. Graefes Arch Clin Exp Ophthalmol 250, 1673–1680 (2012). https://doi.org/10.1007/s00417-012-1998-4

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  • DOI: https://doi.org/10.1007/s00417-012-1998-4

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