Corneal Densitometry in Acute Primary Angle Closure Glaucoma
Condition: Acute Primary Angle-closure Glaucoma
MeSH terms: Glaucoma; Glaucoma, Angle-Closure
Study type: Observational

Summary: 
      Purpose: Our purpose was to investigate the laser peripheral iridotomy (LPI) induced changes
      in corneal densitometry in acute primary angle closure glaucoma (PACG) cases during the
      post-laser 1 month period.

      Material and methods: This prospective study included 21 eyes of 21 cases with first acute
      attack of PACG. All the eyes underwent LPI with neodymium: yttrium-aluminum-garnet (Nd: YAG)
      laser after the intraocular pressure (IOP) decreased to normal levels with maximal systemic
      and topical anti-glaucoma treatment and complete regression of clinically significant corneal
      edema. Central corneal thickness (CCT) and corneal density values were measured by
      densitometry software of Pentacam HR-Scheimpflug corneal topography over a 12-mm diameter of
      the cornea just before LPI and at the first week and the first month after LPI. Kolmogorov
      smirnov and paired-t tests were used for statistical analysis.
    

Detailed description: 
      This prospective study included 21 eyes of 21 cases with first acute attack of PACG who had
      applied to emergency department of Ulucanlar Eye Research Hospital between March 2018 and
      January 2019. All the eyes underwent LPI with neodymium: yttrium-aluminum-garnet (Nd: YAG)
      laser after the IOP decreased to normal levels with maximal systemic and topical
      anti-glaucoma treatment and complete regression of clinically significant corneal edema.

      During the acute attack ocular examination was performed at the emergency department
      including best-corrected visual acuity (BCVA) with Snellen charts, slit-lamb examination,
      fundus examination by +90 D lens, IOP measurements with Goldmann applanation tonometry,
      gonioscopy of the fellow eye with Goldmann three-mirror lens. Gonioscopy and fundus
      examinations were performed for the eyes with acute PACG after the regression of corneal
      edema.

      All the cases had intravenous infusion of mannitol 20% (250-300 cc) at the emergency
      department. Oral acetazolamide 250 mg (3 times daily), oral potassium supplement, topical
      fixed-combination of beta-blocker and carbonic anhydrase inhibitors (twice daily) and
      brimonidine (twice daily). LPI procedures were performed within the first day of the attack
      (after 12-24 hours) by the same experienced physician (OA) with neodymium:
      yttrium-aluminum-garnet (Nd: YAG) laser under topical anesthesia with proparacain %0.5.
      Superior-nasal position (1 or 11 o'clock) was focused and 1 or more shots were performed (1-3
      pulses per shot with 3-8 mJ energy).

      Central corneal thickness (CCT) and CD values were measured by densitometry software of
      Pentacam HR-Scheimpflug corneal topography just before LPI and at the first week and the
      first month after LPI. All the measurements were performed by the same experienced clinician
      between 9 am and 2 pm under standard dim-light conditions without pupil dilatation.
    

Intervention name(s): Corneal densitometry
Intervention type(s): Diagnostic Test
Intervention description(s): Corneal density values were measured by densitometry software of Pentacam HR-Scheimpflug corneal topography
Observational model: Case-Control
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        All patients were Turkish Caucasians with with first attack of primary angle closure
        glaucoma
      
Keywords: Cornea,; density,; laser peripheral iridotomy,; primary angle closure glaucoma