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Is prophylactic laser peripheral iridotomy for primary angle closure suspects a risk factor for cataract progression? The Chennai Eye Disease Incidence Study
  1. Lingam Vijaya1,
  2. Rashima Asokan1,2,3,
  3. Manish Panday1,
  4. Ronnie George1
  1. 1Glaucoma Project, Vision Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
  2. 2Elite School of Optometry, Chennai, Tamil Nadu, India
  3. 3Birla Institute of Technology and Science, Pilani, Rajasthan, India
  1. Correspondence to Dr Lingam Vijaya, Medical Research Foundation, Sankara Nethralaya, 18, College Road, Chennai, Tamil Nadu 600 006, India; cgscedis{at}gmail.com

Abstract

Background To report the risk of cataract progression among primary angle closure suspects (PACS) 6 years after they underwent laser peripheral iridotomy (LPI).

Methods In the Chennai Eye Disease Incidence Study, 6 years after their baseline evaluation, 4421 subjects were examined again. As part of a detailed evaluation cataract was graded using the Lens Opacities Classification System II; progression was defined as change of cataract by two or more grades or history of cataract surgery in the 6-year period. Only bilaterally phakic subjects with less than N2 or C2 or P2 cataract at baseline with no history of any form of glaucoma, primary angle closure and pseudoexfoliation were included.

Results There were 3205 eligible subjects. Of these, 190 had undergone LPI for PACS. In comparison to the study population, they were significantly older (p<0.001), female (p=0.008), urban residents (p=0.001) and patients with hypertension (p<0.001). During the intervening period, 53 subjects had undergone cataract surgery. The cataract progression rate was significantly greater (OR 1.7, 95% CI 1.3 to 2.4, p<0.001) in those who had undergone LPI. For the study population the baseline risk factors for progression of cataract were age (p<0.001), female gender (p=0.01), diabetes (p<0.001) and LPI (p<0.001). Diabetes and female gender were significant risk factors for nuclear and cortical cataract progression; LPI was a risk factor only for cortical cataract (OR 1.6, 95% CI 1.1 to 2.3, p=0.007).

Conclusions There was significant cataract progression in 6 years following LPI for PACS.

  • Glaucoma
  • Epidemiology
  • Lens and zonules
  • Public health
  • Diagnostic tests/Investigation

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