Seminars in ophthalmology · 2023
Effect of Topical Pilocarpine Instilled Before Laser Peripheral Iridotomy on Regional Iris Thickness in Primary Angle Closure Disease: A Swept-Source Anterior Segment Optical Coherence Tomography Pilot Study.
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Kita Yoshiyuki, Hollό Gábor, Mochizuki Tsukasa, Emoto Yoshinobu, Kita Ritsuko, Hirakata Akito
Аннотация
PURPOSE: To determine whether the temporal-superior or the nasal-superior iris area becomes thinner (more optimal) for laser peripheral iridotomy (LPI) after pilocarpine instillation in primary angle closure disease (PACD); and to identify an angle for optimal penetration of the laser beam.
PATIENTS AND METHODS: Iris thickness at 2 mm from the iris root in the preset scanning axes was measured using swept-source anterior segment optical coherence tomography before and 60 minutes after the instillation of pilocarpine 2% in one eye of 30 consecutive Japanese PACD patients with thick, dark brown iris. Iris thickness at 1:30 and 10:30 clock hour positions were evaluated in sagittal and oblique directions, resulting sagittal iris thickness (SIT) and minimum iris thickness (MIT) parameters, respectively.
RESULTS: Compared to the baseline values, iris thickness decreased significantly (P < .001) in both locations after pilocarpine instillation. Both before and after pilocarpine instillation the temporal-superior iris thickness was significantly smaller than the nasal-superior thickness (P ≤ .001). After pilocarpine instillation, the temporal-superior iris was significantly thinner in an approximately 13° angle direction temporal to the sagittal direction than in the sagittal direction (MIT: 0.322 mm; SIT: 0.346 mm, P < .001).
CONCLUSIONS: After pilocarpine instillation, the temporal-superior iris and an approximately 13° angle temporal to the sagittal direction may provide an optimal location and laser beam angle for LPI in PACD eyes.
PATIENTS AND METHODS: Iris thickness at 2 mm from the iris root in the preset scanning axes was measured using swept-source anterior segment optical coherence tomography before and 60 minutes after the instillation of pilocarpine 2% in one eye of 30 consecutive Japanese PACD patients with thick, dark brown iris. Iris thickness at 1:30 and 10:30 clock hour positions were evaluated in sagittal and oblique directions, resulting sagittal iris thickness (SIT) and minimum iris thickness (MIT) parameters, respectively.
RESULTS: Compared to the baseline values, iris thickness decreased significantly (P < .001) in both locations after pilocarpine instillation. Both before and after pilocarpine instillation the temporal-superior iris thickness was significantly smaller than the nasal-superior thickness (P ≤ .001). After pilocarpine instillation, the temporal-superior iris was significantly thinner in an approximately 13° angle direction temporal to the sagittal direction than in the sagittal direction (MIT: 0.322 mm; SIT: 0.346 mm, P < .001).
CONCLUSIONS: After pilocarpine instillation, the temporal-superior iris and an approximately 13° angle temporal to the sagittal direction may provide an optimal location and laser beam angle for LPI in PACD eyes.