Original articles
Iridociliary apposition in plateau iris syndrome persists after cataract extraction

https://doi.org/10.1016/S0002-9394(02)01842-1Get rights and content

Abstract

Purpose

To evaluate the ultrasound biomicroscopic appearance of the anterior segment before and after cataract extraction in eyes with plateau iris syndrome and to determine the effect of postoperative zonular relaxation on ciliary body position.

Design

Interventional case series.

Methods

Eyes with plateau iris syndrome scanned before and after cataract extraction between January 1994 and September 2001 were enrolled. The iridociliary relationship and the anterior chamber depth at a distance of 3 mm from the scleral spur were assessed.

Results

We examined six eyes of six patients. Mean patient age was 74.2 ± 6.4 years (standard deviation [SD]) (range, 65–81 years). Mean refractive error was + 1.0 ± 3.9 diopters [D] (range, −5.75–+5.50), and mean axial length was 21.85 ± 0.77 mm (range, 20.90–22.95 mm). All eyes had undergone laser iridotomy and argon laser peripheral iridoplasty before cataract extraction. Ultrasound biomicroscopy examination revealed a narrow angle and absence of a ciliary body sulcus in all eyes with focal areas of iridotrabecular apposition in three eyes. Following cataract extraction, the anterior chamber depth increased (P = .0006, paired t test), while the iridociliary contact remained unchanged.

Conclusions

Iridociliary apposition persists after cataract extraction in plateau iris syndrome. Whether the cause is congenital or acquired, or both, remains to be determined.

Section snippets

Methods

Eyes with plateau iris syndrome scanned with UBM before and after cataract extraction between January 1994 and September 2001 were enrolled. All cataract surgeries were performed via phacoemulsification with posterior chamber intraocular lens implantation and were without complication. A clinical diagnosis of plateau iris syndrome required the presence of iridotrabecular apposition in the presence of a patent laser iridotomy during darkroom gonioscopy, an iris root angulating forward and then

Results

Six eyes of six patients were enrolled. Mean patient age was 74.2 ± 6.4 (standard deviation [SD]) years (range, 65–81 years). Mean refractive error was +1.0 ± 3.9 diopters [D] (range, −5.75–+ 5.50 D), and mean axial length was 21.85 ± 0.77 mm (range, 20.90–22.95 mm). Clinical examination confirmed the presence of plateau iris syndrome with patent laser iridotomy and prior argon laser peripheral iridoplasty in all study eyes. The fellow eye of each patient had plateau iris configuration or

Discussion

Tornquist12 was the first to use the term plateau iris to describe the appearance of the iris of a 44-year-old man with angle-closure glaucoma, who had a normal anterior chamber depth, flat iris surface, and a sharp backward curvature to the peripheral iris. In 1977, Wand and associates6 differentiated plateau iris configuration from plateau iris syndrome. At the present time, plateau iris configuration refers to an angle appearance in which the iris root angulates sharply forward from its

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    This work was supported in part by The New York Eye and Ear Infirmary Department of Ophthalmology Research Fund, New York, NY (Dr. Tran) and the Donald Engel Research Fund of the New York Glaucoma Research Institute, New York, NY.

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