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Purpose: To evaluate changes in anterior segment morphology following laser peripheral iridotomy (LPI) and trabeculectomy in primary angle closure glaucoma (PACG) using Sirius Scheimpug imaging. Methods: In this prospective study, PACG patients undergoing LPI and trabeculectomy were imaged pre- and post-procedure using the Sirius Scheimpug system. Anterior segment parameters including anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA), iris curvature (I-Curv), and lens vault (LV) were analyzed and compared. Results: 72 eyes of 36 PACG patients were analyzed. At 1 month post-LPI, there was signicant widening of ACA (p<0.001), attening of I-Curv (p=0.002), and lowering of LV (p<0.001) with no change in ACD or ACV. After trabeculectomy, ACD and ACV increased signicantly (p<0.001), along with further ACA widening (p=0.03) and I-Curv attening (p=0.01). LV remained reduced. Conclusions: Sirius imaging allows quantitative assessment of anterior segment changes after LPI and trabeculectomy in PACG. LPI induced morphologic changes consistent with iris prole attening and angle widening. Trabeculectomy additionally increased anterior chamber depth and volume. Scheimpug imaging enables understanding of biomechanical effects of glaucoma surgery.
Mahendra et al. (Fri,) studied this question.