Chaithanya Blevender Singh1 , Sheetal Savur2
BACKGROUND Primary angle-closure glaucoma affects 20 million people worldwide. There is a significantly high incidence of PACG in India, which forms almost half of all adult primary glaucoma seen in a hospital setting. The primary angle closure suspects (PACS) are defined as patients with narrow angles with no evidence of glaucoma or damage to the angle. Half of those blind from glaucoma are due to angleclosure disease. Not all PACS need LPI, as the incidence of acute angle closure in angle closure suspects is not very high according to a few studies. Some studies have shown that LPI may not necessarily widen the angle following iridotomy. We wanted to study the completeness of the pre- and post-procedure evaluation of PACS in terms of gonioscopy and tonometry and the prescription and treatment rate of Nd YAG LPI and its complications in a tertiary hospital. METHODS This is a retrospective analysis of medical case records of patients with angle closure suspects. Data was retrieved from hospital EMR and also from the glaucoma speciality clinics registry. Only PACS were included where at least two quadrants of posterior trabecular meshwork were not visible with normal IOP and with no peripheral anterior synechiae. PAC, PACG, secondary angle closures and all open angle glaucomas were excluded. RESULTS 61 records were included for analysis. 38 (62%) were females and 56 (92%) were bilateral. The pre- and post-procedure IOP performed were 82% and 90% respectively, and gonioscopy performed were 87% and 77% respectively. 53 (86%) were advised LPI and 25 (71.5%) underwent the same immediately. CONCLUSIONS The pre-procedure tonometry and post procedure gonioscopy rates confirming the state of angle anatomy and patency of iridotomy were not satisfactory. The rate of LPI prescription was high. Majority of patients underwent LPI immediately on prescription. Hyphema was the only complication documented.
