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Purpose <p>To evaluate the effects of prophylactic sequential argon- Nd:YAG laser peripheral iridotomy (pLPI<sub>sequential</sub>) on the corneal endothelial cell density (CECD) over 5 years in Japanese eyes with narrow angles (NA-eyes).</p> Study design <p>Prospective observational study</p> Methods <p>The CECD of NA-eyes before and after pLPI<sub>sequential</sub> and of untreated NA-eyes were assessed annually over 5 years with non-contact specular microscopy. Routine ophthalmic examinations and measurements using anterior-segment imaging devices were performed at baseline. The time courses of the CECD were analyzed using a multivariable linear mixed-effect model and factors obtained at baseline.</p> Results <p>Sixty-nine pLPI<sub>sequential</sub>-treated NA-eyes (69 subjects; mean age, 68.9 years) and 67 pLPI<sub>sequential</sub>-untreated NA-eyes (67 subjects; mean age, 64.4 years) were enrolled. In the pLPI<sub>sequential</sub>-untreated NA-eyes, no baseline factors were correlated significantly with the time course of the CECD, and its decline rate −&#xa0;4.7 (95% Confidence interval (I: −&#xa0;13.3 to 4.0) cells/mm<sup>2</sup> was not significant (p = 0.267). In the pLPI<sub>sequential</sub>-treated NA-eyes, the CECD declined with marginal significance −&#xa0;12.2 (−&#xa0;24.7 to 0.3) cells/mm<sup>2</sup>/year (p = 0.0513) over 5 years. Higher laser energy used, thicker iris, and shallower central anterior chamber depth (cACD) at baseline were significantly negatively correlated with the post-laser CECD (p = 0.0092, 0.0119, and 0.0158). No significant difference was seen in the baseline factors-adjusted CECD decline rate (p = 0.262) between both the groups.</p> Conclusion <p>Prophylactic sequential argon-Nd:YAG pLPI<sub>sequential</sub> had no clinically significant effects on the time course of the CECD over 5 years in Japanese NA eyes. However, higher laser energy used, thicker iris, and shallower cACD significantly negatively affected the post-laser CECD.</p>

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Five-year effect of sequential argon-Nd:YAG prophylactic laser peripheral iridotomy on corneal endothelial cell density in Japanese eyes with narrow angles

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  • 发表日期：

    2025年5月26日

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  • Koichi Mishima,
  • Naomi Mataki,
  • Hiroshi Murata,
  • Shinichiro Ohtani,
  • Hiroshi Sakai,
  • Atsuo Tomidokoro,
  • Makoto Aihara,
  • Kazunori Miyata,
  • Aiko Iwase,
  • Makoto Araie

摘要

Purpose

To evaluate the effects of prophylactic sequential argon- Nd:YAG laser peripheral iridotomy (pLPIsequential) on the corneal endothelial cell density (CECD) over 5 years in Japanese eyes with narrow angles (NA-eyes).

Study design

Prospective observational study

Methods

The CECD of NA-eyes before and after pLPIsequential and of untreated NA-eyes were assessed annually over 5 years with non-contact specular microscopy. Routine ophthalmic examinations and measurements using anterior-segment imaging devices were performed at baseline. The time courses of the CECD were analyzed using a multivariable linear mixed-effect model and factors obtained at baseline.

Results

Sixty-nine pLPIsequential-treated NA-eyes (69 subjects; mean age, 68.9 years) and 67 pLPIsequential-untreated NA-eyes (67 subjects; mean age, 64.4 years) were enrolled. In the pLPIsequential-untreated NA-eyes, no baseline factors were correlated significantly with the time course of the CECD, and its decline rate − 4.7 (95% Confidence interval (I: − 13.3 to 4.0) cells/mm2 was not significant (p = 0.267). In the pLPIsequential-treated NA-eyes, the CECD declined with marginal significance − 12.2 (− 24.7 to 0.3) cells/mm2/year (p = 0.0513) over 5 years. Higher laser energy used, thicker iris, and shallower central anterior chamber depth (cACD) at baseline were significantly negatively correlated with the post-laser CECD (p = 0.0092, 0.0119, and 0.0158). No significant difference was seen in the baseline factors-adjusted CECD decline rate (p = 0.262) between both the groups.

Conclusion

Prophylactic sequential argon-Nd:YAG pLPIsequential had no clinically significant effects on the time course of the CECD over 5 years in Japanese NA eyes. However, higher laser energy used, thicker iris, and shallower cACD significantly negatively affected the post-laser CECD.