Determination of anterior segment changes with Pentacam after phacoemulsification in eyes with primary angle-closure glaucoma.

BACKGROUND: To investigate changes of anterior segment morphology in primary angle-closure glaucoma after phacoemulsification using the Pentacam system. DESIGN: Prospective, interventional study, Zhongshan Hospital of Sun Yat-sen University. PARTICIPANTS: Eighty-five eyes from 60 patients with primary angle-closure glaucoma undergoing phacoemulsification. METHODS: Intraocular pressure was measured by Goldmann applanation tonometry. Anterior segment morphology was assessed using the Pentacam camera. MAIN OUTCOME MEASURES: The intraocular pressure, central anterior chamber depth, peripheral anterior chamber depth, anterior chamber volume, pupil diameter and anterior chamber angle preoperative and 3 months postoperative. RESULTS: A total 78 eyes of 55 patients with primary angle-closure glaucoma were included in the analysis. Thirty-two eyes (41.0%) had acute primary angle-closure glaucoma, and 46 eyes (59.0%) had chronic primary angle-closure glaucoma. In both groups, statistically significant decreases in intraocular pressure and increases in anterior chamber volume, central anterior chamber depth, peripheral anterior chamber depth and anterior chamber angle inferiorly, nasally, temporally and superiorly were observed at 3 months after phacoemulsification (all P < 0.001). CONCLUSIONS: Phacoemulsification induces significant changes in anterior segment morphology in primary angle-closure glaucoma accompanied by a significant fall in intraocular pressure in the short term.

Sutureless fixation of amniotic membrane patch as a therapeutic contact lens by using a polymethyl methacrylate ring and fibrin sealant in a rabbit model.

PURPOSE: To introduce and evaluate a sutureless technique by using a polymethyl methacrylate (PMMA) ring and fibrin sealant to fix an amniotic membrane (AM) patch on the ocular surface as a therapeutic contact lens in a rabbit model. METHODS: PMMA rings were fabricated by duplicating an impression of a rabbit conjunctival fornix. The central cornea of the left eye in 16 rabbits was deepithelialized (diameter = 10 mm). A human AM patch was fixed to the ocular surface by using either a PMMA ring and fibrin sealant or interrupted 10-0 nylon sutures. The fibrin sealant was used to create the PMMA ring-AM complex but not to attach the AM/PMMA ring to the ocular surface. The rabbits were followed up with slit-lamp examination and fluorescein staining for 7 days. Reepithelialization and complications were recorded. RESULTS: The corneal epithelial defect was recovered in each rabbit of both groups after 5 days. In the sutureless group, all membranes remained in place and intact during the follow-up period. One eye was noted to have a partial conjunctival epithelial defect caused by exposure to the PMMA ring. In contrast, >50% of rabbits in the interrupted suture group exhibited complications including conjunctival edema, suture loosening, patch detachment, bleeding, and conjunctival epithelial defects. CONCLUSIONS: The sutureless technique that uses a PMMA ring and fibrin sealant for AM patch placement has a lower incidence of complications than the interrupted suture method. This sutureless technique may promote increased clinical use of AM patch by alleviating patients' pain and shortening surgical time.