TY - JOUR
T1 - Zonulopathy Identified During Cataract Extraction in Patients With Primary Angle Closure Disease
AU - Zhang, Hui
AU - Zhang, Ye
AU - Zhang, Shuo
AU - Cao, Kai
AU - Li, Dongjun
AU - Liu, Mugen
AU - Liang, Jing
AU - Song, Jing
AU - Wang, Ningli
AU - Qiao, Chunyan
N1 - Funding Information:
The study is sponsored by the Capital Funds for Health Improvement and Research of China. The Number is CFH 2022-2-2058.
Publisher Copyright:
© 2023 Lippincott Williams and Wilkins. All rights reserved.
PY - 2023/9/1
Y1 - 2023/9/1
N2 - Précis: The proportion, clinical characteristics, and risk factors of zonulopathy in primary angle closure disease (PACD) were analyzed. Zonulopathy is an underrecognized common finding in PACD, especially in patients with acute angle closure (AAC). Purpose: To examine the proportion and risk factors associated with intraoperative zonulopathy in PACD. Patients and Methods: This is a retrospective analysis of 88 consecutive patients with PACD who underwent bilateral cataract extraction at Beijing Tongren Hospital from August 1, 2020 to August 1, 2022. Zonulopathy was diagnosed based on intraoperative findings including the presence of a lens equator, radial folds of the anterior capsule while making capsulorhexis, and other signs of the unstable capsular bag. The subjects were grouped based on their PACD subtype diagnoses: AAC, primary angle closure glaucoma (PACG), primary angle closure (PAC), or primary angle closure suspect (PACS). Multivariate logistic regression was performed to identify risk factors associated with zonulopathy. The proportion and the risk factors of zonulopathy were estimated in patients with PACD and in PACD subtypes. Results: Of 88 patients with PACD (67.3 ± 6.9 y old, 19 males and 69 females), the overall proportion of zonulopathy was 45.5% of patients (40/88) and 30.1% of eyes (53/176). Among the PACD subtypes, the proportion of zonulopathy was highest (69.0%) in AAC, followed by 39.1% in PACG, and 15.3% in PAC and PACS combined. AAC was an independent risk factor associated with zonulopathy (P = 0.015, AAC vs PACG, PAC, and PACS combined; odds ratio: 0.340, CI: 0.142-0.814). Shallower anterior chamber depth (P = 0.031) and greater lens thickness (P = 0.036), but not laser iridotomy, were associated with an increased proportion of zonulopathy. Conclusions: Zonulopathy is common in PACD, especially in patients with AAC. Shallow anterior chamber depth and thick lens thickness were associated with an increased proportion of zonulopathy.
AB - Précis: The proportion, clinical characteristics, and risk factors of zonulopathy in primary angle closure disease (PACD) were analyzed. Zonulopathy is an underrecognized common finding in PACD, especially in patients with acute angle closure (AAC). Purpose: To examine the proportion and risk factors associated with intraoperative zonulopathy in PACD. Patients and Methods: This is a retrospective analysis of 88 consecutive patients with PACD who underwent bilateral cataract extraction at Beijing Tongren Hospital from August 1, 2020 to August 1, 2022. Zonulopathy was diagnosed based on intraoperative findings including the presence of a lens equator, radial folds of the anterior capsule while making capsulorhexis, and other signs of the unstable capsular bag. The subjects were grouped based on their PACD subtype diagnoses: AAC, primary angle closure glaucoma (PACG), primary angle closure (PAC), or primary angle closure suspect (PACS). Multivariate logistic regression was performed to identify risk factors associated with zonulopathy. The proportion and the risk factors of zonulopathy were estimated in patients with PACD and in PACD subtypes. Results: Of 88 patients with PACD (67.3 ± 6.9 y old, 19 males and 69 females), the overall proportion of zonulopathy was 45.5% of patients (40/88) and 30.1% of eyes (53/176). Among the PACD subtypes, the proportion of zonulopathy was highest (69.0%) in AAC, followed by 39.1% in PACG, and 15.3% in PAC and PACS combined. AAC was an independent risk factor associated with zonulopathy (P = 0.015, AAC vs PACG, PAC, and PACS combined; odds ratio: 0.340, CI: 0.142-0.814). Shallower anterior chamber depth (P = 0.031) and greater lens thickness (P = 0.036), but not laser iridotomy, were associated with an increased proportion of zonulopathy. Conclusions: Zonulopathy is common in PACD, especially in patients with AAC. Shallow anterior chamber depth and thick lens thickness were associated with an increased proportion of zonulopathy.
KW - cataract extraction
KW - intraoperative diagnosis
KW - primary angle closure disease
KW - zonulopathy
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U2 - 10.1097/IJG.0000000000002247
DO - 10.1097/IJG.0000000000002247
M3 - Article
C2 - 37311010
AN - SCOPUS:85169181124
SN - 1057-0829
VL - 32
SP - 783
EP - 791
JO - Journal of Glaucoma
JF - Journal of Glaucoma
IS - 9
ER -