Офтальмохирургия (Oct 2015)
ANATOMIC-TOPOGRAPHICAL CHANGES IN THE EYES OF A MIXED FORM OF PRIMARY OPEN-ANGLE GLAUCOMA AFTER LASER IRIDECTOMY
Abstract
Purpose. To investigate anatomic and topographic parameters in patients with a mixed form of primary open-angle glaucoma with the presence of segmental closure of the anterior chamber angle after the performed uncomplicated laser iridectomy.Material and methods. The study included 78 eyes with residual closure of the anterior chamber angle after laser iridectomy, with the preserved shallow anterior chamber, offset forward irido-lens diaphragm and compensated IOP – 19.2±0.16mmHg. The control group included 34 eyes with similar anatomic and topographic parameters without diagnosed glaucoma. Ultrasound biomicroscopy (UBM), B-scan ultrasound and optical coherence tomography of the anterior segment of the eye were used.Results. According to UBM in the study group a high frequency of pseudoexfoliative syndrome of the stages 2-3 was revealed with stretching and rupture of ciliary zonules fibers with pronounced asymmetry in the parameters of the anterior chamber angle, decreasing of the depth of the posterior chamber, increasing the thickness of the lens with its forward shifting. Anatomic and topographic changes of the anterior segment were accompanied by posterior vitreous detachment.Conclusions. Shallow anterior chamber, segmental closure of the anterior chamber angle after the uncomplicated laser iridectomy in patients with a mixed form of glaucoma were caused by an increase in the lens thickness, shifting forward the iris-lens diaphragm and weakness of ciliary zonules. Changes caused by the pseudoexfoliative syndrome contributed to the violation of topographical relations of ocular structures, the segmental closure of the anterior chamber angle and the lack of recovery of anterior chamber depth after laser iridectomy.
