ArticleEye (London, England)2023
PACS plus criteria: a retrospective cohort review of 612 consecutive patients treated with bilateral YAG peripheral iridotomies.
Article in Eye (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed, 1 citations in OpenAlex.
- PACS plus stratification of acute angle closure glaucoma cases: a retrospective analysis.Eye (London, England) · 2026Article
- Outcomes of laser peripheral iridotomy in subgroups of primary angle closure disease eyes according to swept-source optical coherence tomography parameters.Eye (London, England) · 2025Article
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Authors and funding
5 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
introductionWith an ageing population and better life expectancy, the prevalence of angle closure disease is expected to increase by 20% per decade. In 2022, the Royal College of Ophthalmologists (RCOphth) issued a guideline on managing angle closure disease. Hospital eye service (HES) referral and prophylactic treatment are recommended only for primary angle closure suspect (PACS) with "Plus" features only. We aimed to examine patients previously treated with YAG peripheral iridotomies (YAG PI) for the presence of "PACS Plus" features.
methodsA retrospective cohort study of consecutive patients treated with YAG PI between 2015 and 2019 at a tertiary referral NHS eye centre was reviewed. Cases were examined to identify and classify patients into Primary Angle Closure (PAC), PACS, and Primary Angle Closure Glaucoma (PACG). Patients with PACS were studied for "Plus" features.
resultsSix hundred twelve patients with gonioscopy-confirmed angle closure (defined as a minimum 180 degrees iridotrabecular contact) treated with YAG PI from years 2015 to 2019 were included in the analysis. The mean age of patients presenting with angle closure disease was 68.5 years (SD 11.3). There were 390 (63.7%) patients with PACS, 102 (16.6%) with PAC and 120 (19.7%) with PACG. Of the PACS patients, 159(40.8%) patients had no "Plus" features. 181 (40.2%) patients had 1 "Plus" feature, 37 (9.5%) had 2 "Plus" features and 13 (3.3%) patients had 3 "Plus" features.
conclusionIn our cohort, a considerable proportion (40.8%) of PACS patients treated with YAG PI did not have Plus features and therefore that would not meet the proposed criteria for HES referral and YAG PI. With the proposed guidance, we expect a considerable reduction in HES referrals. Nonetheless, community optometry services should be supported and trained to provide monitoring for patients with PACS not referred to the HES.
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